不同介入术式治疗下肢动脉硬化闭塞症临床分析

Clinical Analysis of Different Interventional Operations in Treatment of Patients with Lower Extremity Arteriosclerosis Obliterans

目的探讨不同介入术式治疗下肢动脉硬化闭塞症(ASO)的临床效果。方法选择2011年12月—2015年5月收治的38例(42条患肢)ASO患者。按治疗方法分为A组18例(20条患肢)和B组20例(22条患肢)。A组采用经皮腔内球囊扩张血管成形术,B组在A组基础上采用血管支架植入术治疗。均术后随访12个月,观察两组临床疗效、踝/肱指数(ABI)、术后30 d并发症发生情况、随访12个月动脉通畅率和保肢率及生活质量(QOL)评分。结果两组临床疗效、术后并发症发生率、术后12个月动脉通畅率和保肢率及术后30 d QOL评分比较差异无统计学意义(P>0.05);两组治疗后足背动脉、胫动脉ABI均较治疗前升高,术后6、12个月B组QOL评分高于A组(P<0.05)。结论球囊成形术与球囊成形术联合支架植入术在ASO治疗中均有较好的临床效果,但后者对ASO患者QOL改善明显。

Objective To investigate clinical effects of different interventional operations in treatment of patients with lower extremity arteriosclerosis obliterans （ASO）. Methods A total of 38 patients （42 affected limbs） with lower extremity ASO admitted during December 2011 and May 2015 were divided into group A （n=18, 20 affected limbs） and group B （n=20, 22 affected limbs） according to therapeutic methods. Group A was treated with percutenous translumi-nal angioplasty, while group B was added with intravascular stent implantation based on treatment in group A. After oper-ation, all patients were followed up for 12 months. Clinical curative effects, ankle brachial index （ABI）, incidence rates of complications of postoperative 30 d, arterial patency and limb salvage rates during follow-up for 6 and 12 months and quality of life （ QOL） score during 1-year follow-up in two groups were observed. Results There were no significant differences in curative effect, incidence rate of postoperative complications, QOL scores during postoperative 30 d and ar-terial patency and limb salvage rates during postoperative 6 and 12 months between the two groups （ P〉0. 05 ） . After treatment, values of arteria dorsalis pedis and tibial artery ABI of were higher than those before treatment in two groups. QOL scores in postoperative 6 and 12 months in group B were higher than those in group A （P〈0. 05）. Conclusion Both balloon angioplasty and balloon angioplasty combined with stent implantation have good clinical effect in treatment of ABO patients, and also balloon angioplasty combined with stent implantation can better improve quality of life significant-ly.