[1]陈占,刘军,张军,等.腔内治疗老年下肢动脉硬化闭塞症的近期疗效观察[J].中国微创外科杂志,2018,18(9):822-845.
　Chen Zhan,Liu Jun,Zhang Jun,et al.Short-term Therapeutic Effect of Intracavitary Treatment for Lower Extremity Arteriosclerosis Obliterans[J].Chinese Journal of Minimally Invasive Surgery,2018,18(9):822-845.
点击复制

腔内治疗老年下肢动脉硬化闭塞症的近期疗效观察()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年9期
页码:
822-845
栏目:
临床研究
出版日期:
2018-12-06

文章信息/Info

Title:
Short-term Therapeutic Effect of Intracavitary Treatment for Lower Extremity Arteriosclerosis Obliterans
作者:
陈占; 刘军; 张军; 张在兴; 林瑞敏*
北京市海淀医院普外科北京大学第三医院海淀院区，北京100080
Author(s):
Chen Zhan;  Liu Jun;  Zhang Jun;  et al.
Department of General Surgery, Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing 100080, China
关键词:
动脉硬化闭塞症; 老年; 腔内治疗
Keywords:
Arteriosclerosis obliterans; Elderly; Endovascular treatment
文献标志码:
A
摘要:
目的探讨腔内治疗老年下肢动脉硬化闭塞症的近期疗效。方法回顾性分析2010年1月~2016年6月行腔内治疗的老年下肢动脉硬化闭塞症112例（140条肢体）资料，术后3、6、12个月随访治疗效果。结果成功开通病变肢体129条，手术技术成功率92.1%（129/140），治疗病变血管164支。术后3、6和12个月下肢缺血临床症状Fontaine分期与术前比较均改善(P<0.01)。术后3、6和12个月足背动脉踝肱指数均较术前的0.56±0.32显著增加，分别为0.97±011（t=-13.572，P=0.000），0.85±0.23（t=-11.588，P=0.000），0.71±0.26（t=-6.661，P=0.000）。术后3、6和12个月靶血管的再狭窄率分别为14.4%（23/160）、28.2%（42/149）和43.8%（63/144），无截肢。结论腔内治疗老年下肢动脉硬化闭塞症微创、安全、有效，能迅速恢复下肢血流，改善缺血症状，避免截肢，近期疗效满意。
Abstract:
ObjectiveTo explore the short-term clinical efficacy of intracavitary treatment of lower extremity arteriosclerosis obliterans in the elderly.MethodsA retrospective analysis on 112 cases of elderly patients with lower extremity arteriosclerosis obliterans (140 limbs) treated at our hospital from January 2010 to June 2016 was carried out. The effects of endovascular treatment were followed at 3 months, 6 months and 12 months after operation.ResultsA total of 140 limbs were treated by interventional therapy, 129 of which were opened, with a technical success rate of 92.1% (129/140). The clinical symptoms of lower extremity ischemia at 3 months, 6 months and 12 months after operation were improved as compared with those before operation according to the Fontaine classification (all P<0.01). The ankle-brachial index of dorsalis pedis artery was increased form 0.56±0.32 preoperatively to 0.97±0.11 (t=-13.572, P=0.000), 0.85±0.23 (t=-11.588, P=0.000), and 0.71±0.26 (t=-6.661, P=0.000) at 3, 6 and 12 months after operation, respectively. The re-stenosis rates of target vessels at 3, 6 and 12 months after operation were 14.4% (23/164), 28.2% (42/149) and 43.8% (63/144), respectively. No amputation was required.ConclusionsEndovascular treatment for elderly patients with arteriosclerosis obliterans is a minimally invasive, safe and effective treatment. It can quickly restore blood flow in the lower limb, relieve lower limb ischemic symptoms, increase limb preservation rate and enhance the quality of life. The short-term clinical results are satisfactory.

参考文献/References:

[1]马天宇,谷涌泉,郭连瑞,等.下肢动脉硬化闭塞症外科治疗方法的比较及预后:单中心十年经验.中华外科杂志,2015,53(4):305-309.
[2]庄金满,李选.下肢动脉硬化闭塞症的治疗进展.中国微创外科杂志,2014,14(9):839-843.
[3]Rutherford RB,Baker JD,Ernst C,et al.Recommended standards for reports dealing with lower extremity ischemia: revised version.J Vasc Surg,1997,26(3):517.
[4]Catapano AL,Reiner Z,De Backer G,et al.ESC/EAS Guidelines for the management of dyslipidaemias.The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS).Atherosclerosis,2011,217(1):3-46.
[5]Laird JR,Katzen BT,Scheinert D,et al.Nitinol stent implantation versus balloon angioplasty for lesions in the superficial femoral artery and proximal popliteal artery:twelve-month results from the RESILIENT randomized trial.Circ Cardiovasc Interv,2010,3(3):267-276.
[6]Ferraresi R,Centola M,Ferlini M,et al.Long-term outcomes after angioplasty of isolated, below-the-knee arteries in diabetic patients with critical limb ischaemia.Eur J Vasc Endovasc Surg,2009,37(3):336-342.
[7]Dosluoglu HH,Cherr GS,Lall P,et al.Stenting vs above knee polytetrafluoroethylene bypass for TransAtlantic Inter-Society Consensus-II C and D superficial femoral artery disease.J Vasc Surg,2008,48(5):1166-1174.
[8]中华医学会外科学分会血管外科学组.下肢动脉硬化闭塞症诊治指南.中华医学杂志,2015,95(24):1883-1896.
[9]贾若飞,朱华刚,李响,等.慢性完全闭塞病变中“顽固的近端纤维帽”的治疗策略.中国介入心脏病学杂志,2017,25(1):42-44.
[10]李贝贝,畅智慧,马羽佳,等.Outback导管辅助内膜下成形术治疗下肢动脉硬化闭塞症的文献系统评价.中华放射学杂志,2015，49(2):143-145.
[11]邹君杰,焦元勇,蒋军,等.仰卧位腘动脉逆行入路治疗股腘动脉硬化闭塞症.中国血管外科杂志:电子版,2016,8(1):38-41.
[12]章森苗.经腘动脉入路逆行内膜下血管成形术治疗股浅动脉长段硬化性闭塞症的临床研究.中国普通外科杂志,2015,24(6):818-822.
[13]杜昕,任昊,郭伟,等.下肢动脉粥样硬化闭塞性病变介入治疗的现状及前景.中华实验外科杂志,2017,34(5):894-896.
[14]Inoue T,Node K.Molecular basis of restenosis and novel issues of drug-eluting stents. Circ J,2009,73(4):615-621.
[15]谷涌泉,郭连瑞,郭建明,等.SilverHawk斑块切除联合紫杉醇药物球囊治疗下肢动脉慢性缺血.中国微创外科杂志,2017,17(1):65-68.
[16]Steinkamp HJ,Werk M,Haufe M,et al.Laser angioplasty of peripheral arteries after unsuccessful recanalization of the superficial femoral artery.Int J Cardiovasc Intervent,2000,3(3):153-160.
[17]谷涌泉,郭连瑞,齐立行,等.TurboHawk斑块切除治疗伴严重钙化斑块的下肢动脉硬化闭塞症2例.中国微创外科杂志,2016,16(5):449-451.
[18]房杰,陈学明,李晨宇,等.Rotarex治疗急性/亚急性动脉缺血20例疗效分析.中国循环杂志,2017,32(z1)：173-174.

备注/Memo

备注/Memo:
*通讯作者，E-mail：linmihu@sina.com
更新日期/Last Update: 2018-12-06