改良机械性内膜剥脱技术治疗股浅动脉长段闭塞性病变的应用分析  

Application analysis of modified mechanical endarterectomy in the treatment of long-segment occlusive lesions of superficial femoral artery

作　　者：刘英军 曾昭玲 姚宝洪 王江涛 Liu Yingjun;Zeng Zhaoling;Yao Baohong;Wang Jiangtao(Department of Cardiac and Vascular Surgery,Yantai Affiliated Hospital of Binzhou Medical University,Yantai264100,China)

机构地区：[1]滨州医学院烟台附属医院心脏大血管外科,烟台264100 [2]滨州医学院烟台附属医院普外科,烟台264100

出　　处：《中华血管外科杂志》2024年第6期386-391,共6页Chinese Journal of Vascular Surgery

摘　　要：目的对比分析自主改良机械性内膜剥脱技术与常规内膜剥脱技术治疗下肢动脉长段闭塞性病变的差异。方法本研究为回顾性队列研究。选取2022年7月至2023年7月滨州医学院烟台附属医院心脏大血管外科采用改良机械性内膜剥脱技术治疗12例下肢动脉长段闭塞性病变的患者作为观察组,其中男性9例,女性3例,年龄(79.95±9.32)岁;选取2021年6月至2022年6月采用常规内膜剥脱技术治疗的10例下肢动脉长段闭塞性病变患者作为对照组,其中男性8例,女性2例,年龄(80.90±6.27)岁。采用独立样本t检验和χ^(2)检验或Fisher精确概率法比较两组的手术时间、手术成功率、血管外膜损伤率、术后3个月及6个月通畅率方面的差异。结果观察组手术时间较对照组短[(3.73±1.19)h比(5.99±0.73)h],差异具有统计学意义(t=-5.231,P<0.001);血管外膜损伤率较对照组低[8.3%(1/12)比30%(3/10)],但差异无统计学意义(P=0.293);两组手术成功率、术后3个月及6个月通畅率差异无统计学意义(均P>0.05)。结论改良机械性内膜剥脱技术治疗下肢动脉长段闭塞性病变疗效尚可,在手术时间和血管外膜损伤率方面具有一定优势。ObjectiveTo compare and analyze the modified mechanical endarterectomy with conventional therapy in the treatment of long-segment occlusive lesions of superficial femoral artery.MethodsThe study was a retrospective cohort study.Twelve patients[9 males and 3 females,aged(79.95±9.32)years]with long-segment occlusive lesions of superficial femoral artery admitted to the Department of Cardiovascular and Vascular Surgery,Yantai Affiliated Hospital of Binzhou Medical University from July 2022 to July 2023 were selected as the observation group.The patients underwent surgery using an modified mechanical endarterectomy technique.Ten patients admitted to the same hospital between June 2021 and June 2022,who received conventional endarterectomy,were selected as the control group.Independent samples t-test,Chi-square test and Fisher's exact probability method were used to analyze the differences in operative time,surgical success rate,vascular adventitial injury rate and 3-month and 6-month patency rates in two groups.ResultsThe operative time in the observation group was shorter than that in the control group[(3.73±1.19)h vs(5.99±0.73)h]with statistically significant differences(t=-5.231,P<0.001).The adventitial injury rate in the observation group was lower than that in the control group[8.3%(1/12)vs 30%(3/10)],with no statistically significant differences(P=0.293).No statistically significant differences were found in surgical success rate and 3-month and 6-month patency rates between the two groups(P>0.05).ConclusionThe modified mechanical endarterectomy shows promising results in treating long-segment occlusive lesions of the superficial femoral artery,with potential advantage over conventional therapy in terms of shorter operative time and lower vascular adventitial injury rate.

关 键 词：下肢动脉硬化闭塞症 内膜剥脱技术 介入治疗 血管闭塞 

分 类 号：R654.3[医药卫生—外科学]