忽略股浅动脉重建在治疗慢性下肢动脉硬化闭塞症中的临床意义

发布时间：2018-05-21 18:26

本文选题：下肢动脉硬化闭塞症 + 腔内治疗　；参考：《中国微创外科杂志》2017年01期

【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临床意义。方法回顾分析2003年1月~2013年12月155例(220条患肢)股浅动脉重度狭窄、闭塞的下肢动脉硬化闭塞症的临床资料。根据对股浅动脉的处理方法,将患者分为股浅动脉重建组(107条患肢)和非重建组(113条患肢),比较2组患者的临床疗效。结果重建组近期(出院时)总有效率明显优于非重建组[70.1%(75/107)vs.46.0%(52/113),Z=-2.356,P=0.018],随访期内2组总有效率无统计学差异[53.3%(57/107)vs.57.5%(65/113),Z=-0.633,P=0.527]。2组保肢率无统计学差异[94.4%(101/107)vs.96.5%(109/113),χ~2=0.170,P=0.680]。重建组再次腔内治疗率更高[30.8%(33/107)vs.8.8%(10/113),χ2=16.903,P=0.000],费用更高[(34 658.7±8322.7)元vs.(17 036.6±1603.0)元,t=22.082,P=0.000]。2组围手术期病死率和并发症发生率无统计学差异[0 vs.0.9%(1/113),Fisher精确检验,P=1.000;1.9%(2/107)vs.1.8%(2/113),Fisher精确检验,P=1.000]。结论忽略股浅动脉重建治疗下肢动脉硬化闭塞症安全、有效、经济,应成为部分患者的首选治疗方法。
[Abstract]:Objective to evaluate the clinical significance of neglect of superficial femoral artery reconstruction in the treatment of chronic arteriosclerosis obliterans of lower extremity. Methods from January 2003 to December 2013, 155 cases of lower extremity arteriosclerosis obliterans with severe stenosis and occlusion of superficial femoral artery were retrospectively analyzed. According to the treatment of superficial femoral artery, the patients were divided into superficial femoral artery reconstruction group (107 limbs) and non-reconstruction group (113 limbs). The clinical efficacy of the two groups was compared. Results the total effective rate of the reconstruction group was significantly better than that of the non-reconstruction group [70.1 / 75 / 107vs.46.0 / 522 / 113N Z-2.356P0. 018], and there was no statistical difference in the total effective rate between the two groups during the follow-up period [53.3 / 107vs.57.565 / 6113P 0.527] .2 there was no statistical difference in the limb retention rate of the two groups (94.4101r107vs.96.5109r113, 蠂 2 / 0.170P 0.680). The rate of re-intracavitary treatment was higher in the reconstruction group [30.8% 33% 107vs.8.810% 113N, 蠂 216.903 vs.(17 0.000], and the cost was higher [34 658.7 卤8322.7 yuan vs.(17 036.6 卤1603.0] .2. the perioperative mortality and incidence of complications had no statistical difference in the reconstruction group. Conclusion neglecting superficial femoral artery reconstruction in the treatment of arteriosclerosis obliterans of lower extremity is safe, effective and economical, and should be the first choice for some patients.
【作者单位】：北京大学第三医院介入血管外科;
【分类号】：R543

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