导管溶栓术在治疗下肢慢性缺血性疾病中的应用研究

发布时间：2019-01-30 13:04

【摘要】：目的:分析评价动脉内经导管直接溶栓术在治疗下肢慢性缺血性疾病中的效果及安全性。方法:回顾性总结2013年3月至2014年11月期间我科对下肢慢性缺血性疾病行介入治疗的36例患者临床资料。所有的病例均有明显的慢性缺血病史,出现间歇性跛行或静息痛时间为2-20个月;间歇性跛行距离为20-150米,平均84米。分组情况:先行动脉内经导管直接溶栓、后行经皮腔内血管成形术17例;直接行经皮腔内血管成形术19例。结果:先行溶栓组行导管溶栓术前后狭窄闭塞段血管长度为[(136.8±22.9)mm,(115.4±17.8)mm,t=11.9,P0.05],溶栓术后病变血管段长度明显缩短。先行溶栓组行导管溶栓术前后患肢ABI为[(0.26±0.13),(0.32±0.12),t=-0.46,P0.05]。先行溶栓组和直接经皮腔内血管成形组置入支架数量为[(1.6±0.8)个,(2.1±0.7)个,t=2.1,P0.05];先行溶栓组和直接经皮腔内血管成形组置入支架长度为[(117.6±33.1)mm,(142.1±29.7)mm,t=2.3,P0.05],置入支架数量和长度明显减少。两组间出现并发症情况(先行溶栓组6例,直接经皮腔内血管成形组5例,P0.05)对比无统计学意义。全部病例得到随访12个月,6个月、12个月血管通畅率[(72.7%vs 66.7%)和(70.6%vs 63.2%),P0.05]两组间对比无统计学意义。结论:动脉内经导管直接溶栓术辅助经皮腔内血管成形术对下肢慢性重症缺血性疾病的治疗有很好的效果及安全性,可以有效缩短病变血管长度,减少支架施放数量及长度,减轻患者经济负担。
[Abstract]:Objective: to evaluate the efficacy and safety of direct catheter thrombolysis in the treatment of lower extremity chronic ischemic diseases. Methods: the clinical data of 36 patients with chronic ischemic disease of lower extremity who were treated with interventional therapy from March 2013 to November 2014 were retrospectively summarized. The duration of intermittent claudication or resting pain was 2-20 months, and the distance of intermittent claudication was 20-150 m, with an average of 84 m. Group: 17 cases received percutaneous transluminal angioplasty and 19 cases received direct percutaneous transluminal angioplasty. Results: in the thrombolytic group, the length of stenosis and occlusion was (136.8 卤22.9) mm, (115.4 卤17.8) mm,t=11.9,P0.05 before and after catheter thrombolysis. In the thrombolytic group, the ABI of the affected limb before and after catheter thrombolysis was (0.26 卤0.13), (, 0.32 卤0.12); The number of stents in thrombolytic group and direct percutaneous angioplasty group was (1.6 卤0.8), (2.1 卤0.7), (2.1 卤0.7) respectively. The length of stent in thrombolytic group and direct percutaneous angioplasty group [(117.6 卤33.1) mm, (142.1 卤29.7) mm,t=2.3,P0.05] was significantly decreased. There was no significant difference in complications between the two groups (6 cases in thrombolytic group and 5 cases in direct percutaneous angioplasty group (P0.05). All patients were followed up for 12 months, 6 months, 12 months, the patency rate of blood vessel [(72.7%vs 66.7%) and (70.6%vs 63.2%), P0.05] there was no significant difference between the two groups. Conclusion: direct transcatheter thrombolysis combined with percutaneous transluminal angioplasty is effective and safe in the treatment of chronic ischemic diseases of the lower extremities. It can effectively shorten the vascular length and reduce the number and length of stent placement. Lighten the patient's economic burden.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.4

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