[1]庄金满,李选﹡,李天润,等.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[J].中国微创外科杂志,2017,17(1):33-37.
　Zhuang Jinman,Li Xuan,Li Tianrun,et al.Clinical Significance of Neglecting Superficial Femoral Artery Reconstruction for Chronic Lower Extremity Arteriosclerosis Obliterans[J].Chinese Journal of Minimally Invasive Surgery,2017,17(1):33-37.
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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()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年1期
页码:
33-37
栏目:
临床论著
出版日期:
2017-04-18

文章信息/Info

Title:
Clinical Significance of Neglecting Superficial Femoral Artery Reconstruction for Chronic Lower Extremity Arteriosclerosis Obliterans
作者:
庄金满; 李选﹡; 李天润; 赵军; 傅军; 栾景源; 王昌明; 张龙; 冯琦琛; 韩金涛
北京大学第三医院介入血管外科，北京100083
Author(s):
Zhuang Jinman;  Li Xuan;  Li Tianrun;  et al.
Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing 100083, China
关键词:
下肢动脉硬化闭塞症; 腔内治疗; 股浅动脉; 外周动脉疾病
Keywords:
Lower extremity arteriosclerosis obliterans; Endovascular therapy; Superficial femoral artery; Peripheral arterial disease
文献标志码:
A
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）， χ2=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:
ObjectiveTo study the clinical significance of neglecting superficial femoral artery reconstruction for chronic lower extremity arteriosclerosis obliterans.MethodsOne hundred and fifty-five patients (220 limbs) treated for sever stenosis or occlusion of superficial femoral artery resulted by arteriosclerosis obliterans in ten years were reviewed. Among them there were 107 limbs treated by endovascular reconstruction of superficial femoral artery (reconstruction group) and the other 113 limbs were only treated with the accompanied iliac and/or profunda femoral artery lesion without superficial femoral artery treatment (non-reconstruction group).ResultsCompared with the non-reconstruction group, the reconstruction group had a better short-term total effective rate ［70.1%(75/107) vs. 46.0%(52/113), Z=-2.356, P=0.018］.There were no significant differences between the two groups on long-term total effective rate ［53.3%(57/107) vs. 57.5%(65/113), Z=-0.633, P=0.527］ and limb salvage rate ［94.4%(101/107) vs. 96.5%(109/113), χ2=0.170, P=0.680］. The reconstruction group had a higher re-operation rate ［30.8%(33/107) vs. 8.8%(10/113), χ2=16.903, P=0.000］ and a higher cost ［(34 658.7±8322.7) yuan vs.(17 036.6±1603.0) yuan, t=22.082, P=0000］ as compared with the non-reconstruction group. There was no significant difference between the two groups on the morbidity of complications and death ［0 vs. 0.9%(1/113), Fisher’s exact test, P=1.000; 1.9%(2/107) vs. 1.8%(2/113), Fisher’s exact test,P=1.000］. ConclusionDealing with accompanied iliac and profunda artery lesion and neglecting superficial femoral artery reconstruction is a safe, effective and inexpensive therapy for lower extremity arteriosclerosis obliterans, and should be the preferred alternative for some patients.

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备注/Memo

备注/Memo:
﹡通讯作者，E-mail：13701091788@139.com
更新日期/Last Update: 2017-04-18