血栓闭塞性脉管炎的外科治疗效果

Surgical treatment effect of thromboangiitis obliterans

目的探讨血栓闭塞性脉管炎的外科治疗效果。方法选取我院2011年5月~2016年5月收治的血栓闭塞性脉管炎患者80例(80条患肢),依据随机数字表法将患者分为单独动脉直接重建术治疗组(单独治疗组,n=40)和动脉直接重建术联合自体骨骼干细胞移植治疗组(联合治疗组,n=40),对两组患者的VAS评分、间歇性跛行距离、ABI变化情况、足部溃疡情况、复发、截肢、死亡情况进行统计分析。结果联合治疗组患者的VAS评分、ABI显著低于单独治疗组(P<0.05),间歇性跛行距离显著长于单独治疗组(P<0.05),足部溃疡治疗的总有效率[95.0%(38/40)]显著高于单独治疗组[70.0%(28/40)](P<0.05),复发率、截肢率、死亡率[7.5%(3/40)、2.5%(1/40)、0]均显著低于单独治疗组[15.0%(6/40)、10.0%(4/40)、5.0%(2/40)](P<0.05)。结论血栓闭塞性脉管炎的动脉直接重建术联合自体骨骼干细胞移植治疗效果较单独动脉直接重建术好,值得推广。

Objective To investigate the surgical treatment effect of thromboangiitis obliterans. Methods Eighty patients （80 limbs） of thromboangiitis obliterans in our hospital from May 2011 to May 2016 were enrolled in this study. These patients were divided into two groups including individual arterial direct reconstruction treatment group （separate treat- ment group, n=40） and arterial direct reconstruction combined with autologous bone stem cell transplantation treatment group （combination treatment group, n=40）, according to the random number table method. The VAS score, intermittent claudication distance, ABI changes, foot ulcers, recurrence, amputation, and death between the two groups were com- pared. Results The VAS score and ABI in the combination treatment group were significantly lower than those in the separate treatment group（P〈0.05）. The intermittent claudication distance was significantly longer than that of the separate treatment group（P〈0.05）. The total effective rate of the foot ulcer 95.0%（38/40） was significantly higher than 70.0%（28/40） of the separate treatment group（P〈0.05）. The recurrence rate, amputation rate and mortality rate were 7.5%（3/40）, 2.5% （1/40） and 0 respectively, which were significantly lower than 15.0% （6/40）, 10.0% （4/40）, 5.0% （2/40） in the separate treatment group （P〈0.05）. Conclusion The treatment effect of direct arterial reconstruction combined with autologous bone stem cell transplantation in thromboangiitis obliterans is greater than that of direct arterial reconstruction, which is worthy of promotion.