准分子激光销蚀术治疗下肢血栓闭塞性脉管炎的回顾性分析

Retrospective analysis of excimer laser atherectomy in thromboangiitis obliterans of lower extremities

目的 探讨准分子激光销蚀术(ELA)对下肢血栓闭塞性脉管炎(TAO)的疗效.方法 收集2019年10月至于2020年10月于新疆维吾尔自治区人民医院采用ELA治疗的20例下肢TAO患者的临床资料.比较所有患肢手术前后的手术成功率,术后3 d及术后6个月的保肢率、视觉模拟评分法(VAS)评分,以及Rutherford分级情况.观察术后6个月的并发症发生情况.结果 20例下肢TAO患者共24条肢体均接受了ELA加或不加普通球囊扩张治疗.24条患肢的手术成功率均为100%.经随访,术后3 d及术后6个月的保肢率均为90%.术后3 d及术后6个月的VAS评分分别为(1.45±0.61)分和(0.85±0.75)分,均明显低于术前的(5.75±1.02)分,差异均有统计学意义(P<0.05).与术前相比,患者术后3 d及术后6个月的Rutherford分级明显降低,差异均有统计学意义(P<0.05).术后6个月,无严重并发症发生.结论 ELA用于治疗下肢TAO患者是安全有效的.

Objective To investigate the efficacy of excimer laser atherectomy(ELA)in thromboangiitis obliterans(TAO)of lower extremities.Method The data of 20 patients with TAO treated with ELA in People’s Hospital of Xinjiang Uygur Autonomous Region from October 2019 to October 2020 were collected.The success rate before and after operation,extremity salvage rate 3 days and 6 months after operation,visual analogue scale(VAS)score and Rutherford grade were compared.Result A total of 24 extremities of 20 patients with TAO were given ELA with or without common balloon dilatation.The success rate of 24 affected extremities was 100%.After follow-up,the extremity salvage rate was 90%at 3 days and 6 months after operation.The VAS scores of 3 days and 6 months after operation were(1.45±0.61)scores and(0.8±0.75)scores respectively,which were significantly lower than that of(5.75±1.02)scores before operation(P<0.05).The Rutherford grade of the patients decreased significantly at 3 days and 6 months after operation compared with that before operation(P<0.05).No serious complications occurred 6 months after operation.Conclusion ELA is safe and effective in the treatment of TAO.