外周动脉阻塞性病变的血管内介入治疗

Interventional Therapy of Peripheral Arterial Occlusion

目的探讨外周动脉阻塞性病变的血管内介入治疗价值。方法58例外周动脉阻塞性患者按治疗方式分为3组:常规动脉内导管药物溶栓者18例(A组),改良动脉内导管药物溶栓者23例(B组),超声消融结合导管内药物溶栓者17例(C组)。溶栓后球囊成形者26例,同时行内支架置入者18例。结果58例外周动脉闭塞均溶栓成功,无1例发生并发症者。A、B、C三组的平均溶栓时间分别为17.8±8.6、11.6±5.2和7.3±3.5h,C组的溶栓时间明显短于A、B组(P<0.05)。A、B、C三组的平均尿激酶用量分别为121.5±52.7,102.2±38.4和34.9±10.3万u,C组的平均尿激酶用量明显少于A、B组(P<0.05)。结论血管内介入治疗是外周动脉阻塞性病变安全有效的治疗方法。

Objective To explore the value of interventional therapy of the peripheral arterial occlusion. Methods 58 patients (37men,21 woman;aged 27-64;average age ,42.5±10.6) were divided into three groups. 18 patients were treated with traditional intravascular thrombolysis in group A,and 23 patients with the improved intravascular thrombolysis in group B. Group C were administrated from artery with ultrasound ablation, combined with traditional intravascular thrombolysis in 17 patients. 26 patients were managed with PTA after thrombolysis ,and 18 patients with stent placement at the same time . Results Occluded arteries were recanalized successfully in all cases without any complication. The mean time of thrombolysis of the group A,B and C was 17. 8±8. 6,11. 6±5. 2 and 7. 3±3. 5 h,respectively. The mean time of group C was shorter than that of the other groups (P<0. 05). The mean dose of urokinase(UK) of the group A,B and C was 1 215 000±527 000,1 022 000±384 000 and 349 000±103 000 u,respectively. The mean dose of UK of group C was less than that of the other groups (P < 0. 05 ). Conclusion Interventional therapy is a safe and effective treatment for the peripheral arterial occlusion.