下肢血栓闭塞性脉管炎的临床治疗体会

Clinical treatment of thromboangiitis obliterans of lower extremities

目的探讨下肢血栓闭塞性脉管炎介入腔内治疗与传统开放手术临床疗效对比。方法选取2011年11月至2016年11月下肢血栓塞性脉管炎患者92例,根据治疗方法分为对照组和观察组,对照组共28例采用传统手术治疗,观察组共64例采用介入腔内治疗,比较两组患者临床疗效。结果两组患者患肢治疗后半年最大行走距离及ABI较治疗前明显改善(P<0.05),观察组患者最大行走距离明显优于对照组(P<0.05);但两组患肢踝肱指数(ABI)比较差异无统计学意义(P>0.05);观察组总有效率为92.2%明显高于对照组78.6%(P<0.05);对照组并发症发生率(3.6%)高于观察组(3.1%),但差异无统计学意义(P>0.05)。结论介入腔内治疗可明显改善下肢血栓闭塞性脉管炎患者的临床症状、体征,有高治愈率,高安全性,小创伤性的优势,有临床推广价值。

Objective To explore the clinical efficacy of the interventional endovascular treatment and traditional surgical therapy for thromboangiitis obliterans（TAO） of lower extremities. Methods From November 2011 to November 2016, 92 patients with lower extremity thrombo-vasculitis were divided into control group and observation group according to the method of treatment. A total of 28 patients in the control group were treated by conventional surgery. A total of 64 patients Endovascular treatment, the clinical efficacy of two groups were compared. Results The maximal walking distance and ABI in the two groups after operation were significantly improved（P〈0.05）, and the maximum walking distance in the observation group was significantly better than that in the control group（P〈0.05）. However, the ankle-brachial index（P〈0.05）. The total effective rate was 92.2% in observation group and 78.6% in control group（P〈0.05）. The incidence of complications in control group（3.6%） was higher than that in observation group（3.1%）, but the difference was not statistically significant（P〉0.05）. Conclusion Interventional therapy can significantly improve the clinical symptoms and signs of patients with lower extremities thromboangiitis obliterans. It has the advantages of high cure rate, high safety and small trauma, and has the value of clinical promotion.