影响下肢动脉硬化闭塞症腔内支架成形术后缺血症状复发的多因素分析

发布时间：2018-07-06 08:15

本文选题：下肢动脉硬化闭塞症 + 球囊扩张　；参考：《中国血管外科杂志(电子版)》2014年04期

【摘要】：目的探讨影响下肢动脉硬化闭塞症腔内支架成形术术后下肢缺血症状复发的相关因素。方法回顾性分析2008年4月至2014年4月乌鲁木齐新疆维吾尔自治区人民医院收治的69例(共70条患肢)下肢动脉硬化闭塞症行腔内支架成形术术后下肢缺血症状复发患者的临床资料,采用寿命表法计算患者血管通畅率,用long-rank检验进行单因素分析,应用COX模型进行症状复发的多因素分析。结果 68例(69条患肢)患者获得随访,随访时间6~72个月。半年、1、3、5年通畅率分别为90%、71%、39%及31%。2例行踝以上截肢术,保肢率为97.1%。随访中死亡6例。术后22例症状复发。单因素分析表明:术后停用抗血小板聚集及降脂药物、功能锻炼对症状复发有影响(P0.05)。多因素分析显示:术后停用抗血小板聚集及降脂药物是影响术后缺血症状复发的独立危险因素(P0.05)。结论是否长期坚持服用抗血小板药物和降脂药物是影响术后缺血症状复发的相关危险因素。腔内支架成形术术后良好的随访及依从性对症状复发可起到预防作用。
[Abstract]:Objective to investigate the related factors influencing the recurrence of lower extremity ischemic symptoms after stenting in lower extremity arteriosclerosis obliterans. Methods from April 2008 to April 2014, 69 patients (70 limbs) with lower extremity arteriosclerosis obliterans treated in Xinjiang Uygur Autonomous region people's Hospital of Urumqi were analyzed retrospectively. The clinical data of the patients, The blood vessel patency rate was calculated by life table method, single factor analysis by long-rank test and multivariate analysis of symptom recurrence by Cox model. Results 68 patients (69 limbs) were followed up for 6 ~ 72 months. The patency rates were 90.71% and 31.2 cases with amputation above the malleolus, respectively, and the limb salvage rate was 97.1%. 6 cases died during follow-up. Postoperative symptoms recurred in 22 cases. Univariate analysis showed that antiplatelet aggregation and antilipidemic drugs were stopped after operation, and functional exercise had an effect on the recurrence of symptoms (P0.05). Multivariate analysis showed that antiplatelet aggregation and antilipidemic drugs were independent risk factors for the recurrence of ischemic symptoms after operation (P0.05). Conclusion long-term anti-platelet and anti-lipid drugs are the risk factors for the recurrence of ischemic symptoms after operation. Good follow-up and compliance after endovascular stenting may prevent the recurrence of symptoms.
【作者单位】：石河子大学医学院;新疆维吾尔自治区人民医院血管外科;
【分类号】：R654.4

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