髂动脉至股深动脉腔内成形术治疗下肢动脉硬化闭塞症患者疗效及并发症

发布时间：2018-04-20 04:40

本文选题：下肢动脉硬化闭塞症 + 髂动脉—股深动脉开口处　；参考：《吉林大学》2015年硕士论文

【摘要】：下肢动脉硬化闭塞症(lower extremity arteriosclerosis obliterans.LEASO)是指动脉粥样硬化斑块的形成，引起多节段动脉的狭窄、闭塞，而导致肢体的慢性缺血性疾病。针对LEASO的治疗方法虽多，但都存在着不足，有部分患者常规的药物治疗其效果并不满意，传统的手术治疗创伤大、术后再狭窄、并发症较高等问题。近年来随着医学的发展，腔内介入治疗以创伤小、具有可重复性、安全性高、术后并发症少等优势，现已成为下肢动脉硬化闭塞症的首选治疗。目的：探讨髂动脉—股深动脉开口处腔内成形术治疗下肢动脉硬化闭塞症的临床疗效。方法：选取我院收治的87例下肢动脉硬化闭塞症病人的完整的病史资料及相关的随访资料进行研究，其中男性53例，女性34例，平均年龄80.40±4.6岁。32例行髂动脉及股浅动脉狭窄或闭塞病变血管球囊扩张+支架植入术，设为A组；27例行髂动脉—股深动脉开口处腔内成形术，股浅动脉的长段病变未做处理，设为B组；28例患肢远端无流出道，，无法行手术治疗的患者，行常规的药物治疗，设为C组。分析治疗前后临床症状、ABI值的改变、跛行距离、保肢率及术后并发症等相关指标进行分析。结果：患者治疗后Rutherford分级均比治疗前有明显改善，24个月后A、B组所有患者的临床症状、ABI值的改变、跛行距离、保肢率均优于C组。A组的ABI值的改变、跛行距离优于B组，两者保肢率无明显差异。B组术中及术后并发症明显低于A组。结论：对于高龄、全身状态差、手术风险较高，而且远端流出道差的病人，行髂动脉—股深动脉开口处腔内成形术治疗下肢动脉硬化闭塞症。该术式可有效的改善下肢缺血的症状，降低截肢率，明显缩短手术时间，降低手术风险，增加手术成功率。缩短疾病的疗程，降低手术费用。
[Abstract]:Lower extremity arteriosclerosis obliterans (lower extremity arteriosclerosis obliterans.LEASO) refers to the formation of atherosclerotic plaque, which causes the stenosis and occlusion of multiple segmental arteries and causes chronic ischemic diseases of the limbs. Although there are many methods of treatment for LEASO, there are shortcomings in the treatment of LEASO. In recent years, with the development of medicine, endovascular interventional therapy has the advantages of small trauma, repeatability, high safety, and less postoperative complications. It has become the first choice for the treatment of arteriosclerosis closure of lower extremity.
Objective: To investigate the clinical effect of iliac artery - deep femoral artery opening angioplasty for the treatment of arteriosclerosis obliterans.
Methods: a total of 87 patients with arteriosclerosis obliterans in our hospital were selected to study the complete medical history data and related follow-up data, including 53 males and 34 females, with the average age of 80.40 + 4.6 years old.32 routine iliac artery and superficial femoral artery stenosis or occlusive vascular balloon dilatation + stent implantation, group A and 27 routine iliac iliac. There was no treatment for the long segment lesion of the superficial femoral artery in the B group. 28 patients who had no flow out of the distal limb and no surgical treatment were treated with conventional medication and set up as group C. The clinical symptoms, the changes of ABI, the distance of limping, the rate of limb salvage and postoperative complications were analyzed. Carries on the analysis.
Results: after the treatment, the Rutherford classification was significantly better than before the treatment. After 24 months, the clinical symptoms, the changes of ABI value, the distance of limping, the rate of limb salvage of all the patients in group B were better than that of the.A group in the C group, and the distance of limping was better than that of the B group. There was no obvious difference in the rate of limb salvage between the two groups in the group of.A and the postoperative complications of the group of the group B. The complications were obviously lower than the A group.
Conclusion: for the elderly, poor systemic state, high risk of operation, and the patients with poor distal outflow tract, the iliac artery and the deep femoral artery openings are treated with internal angioplasty for the treatment of arteriosclerosis obliterans of the lower extremities. This method can effectively improve the symptoms of lower limb ischemia, reduce the rate of amputation, shorten the operation time, reduce the risk of operation and increase the operation. The success rate shortens the course of disease and reduces the cost of operation.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.4

【相似文献】