股浅动脉重建对下肢动脉硬化闭塞症治疗的随机病例对照研究

发布时间：2018-02-20 23:13

本文关键词： 导管插入术外周外周动脉疾病动脉硬化闭塞性腔内治疗股浅动脉病例对照研究　出处：《北京大学学报(医学版)》2017年01期 　论文类型：期刊论文

【摘要】：目的:评价忽略股浅动脉重建治疗慢性下肢动脉硬化闭塞症的安全性和有效性。方法:应用前瞻性的随机病例对照研究方法对忽略股浅动脉重建治疗慢性下肢动脉硬化闭塞症的有效性和安全性进行评价,将北京大学第三医院2014年5月至2015年3月36例下肢动脉硬化闭塞症患者随机分为股浅动脉重建组(20条患肢)和非重建组(16条患肢),重建组均采用腔内治疗重建股浅动脉血运,非重建组均不重建股浅动脉,仅处理同时存在的髂动脉及股深动脉病变,比较两组患者临床疗效、并发症及治疗费用。结果:两组患者的年龄、性别构成、治疗前踝肱指数、TASC(trans-atlantic inter-sociery consensus)分级及Rutherford分级均具有可比性(P0.05),术后1周内重建组显效率和总有效率均优于非重建组[75.0%vs.12.5%(P0.001);90.0%vs.37.5%(P=0.001)],两组均无围手术期并发症及死亡病例。3个月随访时重建组显效率优于非重建组[65.0%vs.25.0%(P=0.017)],两组总有效率差异无统计学意义[85.0%vs.68.8%(P=0.422)];6个月和12个月随访时两组显效率及总有效率差异均无统计学意义[显效率60.0%vs.37.5%(P=0.180),80.0%vs.87.5%(P=0.672);总有效率60.0%vs.43.8%(P=0.332),85.0%vs.87.5%(P=1.000)],重建组治疗费用高于非重建组[(53 367.4±24 518.3)元vs.(30 397.5±15 354.4)元(P=0.011)]。重建组随访期间发现股浅动脉再狭窄/闭塞者8例,其中3例再次介入治疗,再次腔内治疗率为15.0%。结论:忽略股浅动脉重建治疗慢性下肢动脉硬化闭塞症安全、有效、经济,可以作为部分外周动脉疾病患者的首选治疗方法。
[Abstract]:Objective: to evaluate the safety and efficacy of neglect superficial femoral artery reconstruction in the treatment of chronic arteriosclerosis obliterans of lower extremity. Methods: a prospective randomized case-control study was used to treat chronic lower extremity motility with neglect of superficial femoral artery reconstruction. To evaluate the efficacy and safety of pulse sclerosing obliteration, From May 2014 to March 2015, 36 patients with arteriosclerosis obliterans of lower extremity were randomly divided into superficial femoral artery reconstruction group (n = 20) and non-reconstruction group (n = 16). In the non-reconstruction group, the superficial femoral artery was not reconstructed, but the lesions of iliac artery and deep femoral artery were only treated. The clinical efficacy, complications and cost of treatment were compared between the two groups. Results: the age and sex composition of the two groups were compared. Before treatment, the malleolus brachial index (malleolus brachial index) and the Rutherford grade were comparable (P 0.05). The effective rate and the total effective rate in the reconstruction group were higher than those in the non-reconstruction group within one week after operation [75.0 vs.12.5mb P 0.001]. There were no perioperative complications and death cases in both groups. The effective rate of the construction group was better than that of the non-reconstruction group [65.0 vs.25.00.0.17], and there was no significant difference in the total effective rate between the two groups [85.0 vs.68.8and P0.422]; there was no significant difference in the effective rate and the total effective rate between the two groups at the follow-up of 6 and 12 months [the significant efficiency was 60.0vs.37.50.180vs.87.5vs.87.5P0.672; the total effective rate was 60.0vs.43.8m P0.332ng. 85.0vs.87.50.000]. The cost was higher than that in the non-reconstruction group [53 367.4 卤24 518.3 vs.(30 397.5 卤15 354.4]. In the reconstruction group, the superficial femoral artery restenosis / occlusion was found in 8 cases during the follow-up. Conclusion: ignoring the reconstruction of superficial femoral artery in the treatment of chronic lower extremity arteriosclerosis obliteration is safe, effective and economical, and can be used as the first choice for some patients with peripheral artery disease.
【作者单位】：北京大学第三医院介入血管外科;
【分类号】：R654.4

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