经皮腔内血管成形术在下肢动脉硬化闭塞症患者中的价值  

Value of percutaneous transluminal angioplasty in reconstructing for lower extremity arteriosclerotic obliterans

作　　者：楚皓源 娄浩然 秦小玉 CHU Hao-yuan;LOU Hao-ran;QIN Xiao-yu

机构地区：[1]郑州大学附属郑州中心医院血管外科,河南郑州450000

出　　处：《中国疗养医学》2024年第11期96-100,共5页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨经皮腔内血管成形术在重建下肢动脉硬化闭塞症患者靶病变血运及改善下肢神经传导速度中的效果。方法选取2021年7月至2023年7月郑州大学附属郑州中心医院收治的98例下肢动脉硬化闭塞症患者进行研究。采用随机数字表将患者分成两组,各49例。对照组行股动脉内膜剥脱术结合腔内治疗,观察组行经皮腔内血管成形术治疗。比较两组患者的手术效果、患肢循环情况、下肢神经传导速度、炎性因子以及随访3个月并发症的发生情况。结果观察组术后24 h经皮氧分压(transcutaneous oxygen pressure,TcPO2)、踝肱指数(ankle-brachial index,ABI)、趾肱指数(toe-brachial index,TBI)均高于对照组,差异有统计学意义(P<0.05);观察组术后24 h皮肤温度、血流速度均高于对照组,周径增长长度短于对照组,差异有统计学意义(P<0.05);观察组术后24 h感觉神经传导速度(sensory nerve conduction velocity,SNCV)、运动神经传导速度(MNCV)均高于对照组,差异有统计学意义(P<0.05);观察组术后24 h血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1(interleukin-1,IL-1)、白细胞介素-6(interleukin-6,IL-6)检测结果均低于对照组,差异有统计学意义(P<0.05);观察组随访3个月并发症总发生率4.08%低于对照组16.33%(P<0.05)。结论经皮腔内血管成形术在重建下肢动脉硬化闭塞症患者靶病变血运及改善下肢神经传导速度中效果显著,能够有效改善患肢循环,且并发症少。Objective To investigate the effect of percutaneous transluminal angioplasty(PTA)on reconstructing targeted lesion blood flow and improving lower limb nerve conduction velocity in patients with lower-limb arteriosclerosis obliterans(LLASO).Methods A total of 98 patients with LLASO admitted in the Zhengzhou Central Hospital Affiliated to Zhengzhou University from July 2021 to July 2023 were recruited.They were randomly assigned into the control group(n=49)and observation group(n=49).Patients in the control group received femoral endarterectomy combined with intracavitary treatment,and those in the observation group received PTA.The operative effect,circulation of affected limb,nerve conduction velocity of lower limb,inflammatory factors and complications at 3 months follow-up were compared between the two groups.Results The 24-h postoperative transcutaneous oxygen pressure(TcPO2),ankle-brachial index(ABI),and toe-brachial index(TBI)were significantly higher in the observation group than those of control group(P<0.05).At 24 h after operation,skin temperature and blood flow velocity in the observation group were significantly higher than those of control group,and the circumference growth length was significantly shorter(P<0.05).At 24 h postoperatively,sensory nerve conduction velocity(SNCV)and motor nerve conduction velocity(MNCV)in the observation group were significantly higher than those of the control group(P<0.05).Serum tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)and interleukin-6(IL-6)at 24 h postoperatively in the observation group were all significantly lower than those of the control group(P<0.05).The total complication rate of the observation group at 3 months of follow-up was significantly lower than that of the control group(4.08%VS 16.33%,P<0.05).Conclusion PTA is effective in reconstructing targeted lesion blood flow and improving nerve conduction velocity of lower extremity in LLASO patients,which can effectively improve circulation of affected limb with few complications.

关 键 词：下肢动脉硬化闭塞症 经皮腔内血管成形术 血运 下肢神经传导速度 并发症 

分 类 号：R47[医药卫生—护理学]