经皮血管腔内血管成形术治疗股浅动脉长段闭塞症的临床疗效及安全性

Therapeutic effects and safety of percutaneous transluminal angioplasty on occlusion of superficial femoral artery long segment

目的探讨经皮血管腔内血管成形术(PTA)治疗股浅动脉长段闭塞症患者的临床疗效及安全性。方法回顾性分析住院部住院并接受PTA治疗的36例股浅动脉长段闭塞症患者的临床病例资料,总结分析下肢股浅动脉长段闭塞治疗的方式。结果与术前患肢踝肱指数(ABI)相比较,术后患肢ABI显著性升高;36例患者Fontaine分级均至少上升1级;与术前比较,36例手术成功的患者的静息痛、间歇性跋行、患肢局部皮温皮色、患侧足背动脉及胫后动脉恢复搏动及患侧足部溃疡愈合等临床症状均有明显改善,临床总改善率为92.44%;术后1个月一期通畅率为97.62%、二期通畅率为100%;术后6个月一期通畅率为85.37%、二期通畅率为92.68%;术后12个月一期通畅率为63.64%,二期通畅率为84.85%;术后36个月一期通畅率为46.15%,二期通畅率为69.23%;术后1个月及6个月的保肢率均为100%,术后12个月的保肢率为96.97%,术后36个月的保肢率为92.31%。保肢率分析(Kaplan-Meier)表明:不同的性别,病程及股浅动脉闭塞长度,其保肢率有一定差异,其中病程亚组间为显著(P<0.05)。结论 PTA治疗股浅动脉长段闭塞症具有良好的安全性和临床有效性,治疗后患者跋行距离明显增加,并且ABI有明显改善,值得广泛应用于临床。

Objective To observe the therapeutic effects and safety of percutaneous transluminal angioplasty(PTA)on occlusion of superficial femoral artery long segment.Methods The clinical data about 36 patients with occlusion of superficial femoral artery long segment who were treated in our hospital from January 2012 to December 2013 were retrospectively analyzed,moreover the therapeutic ways were analyzed.Results As compared with that of affected limb before operation,the ABI after operation was significantly increased(P<0.05).The Fontaine classification of 36 patients was increased at least 1 level,moreover,as compared with those before treatment,the clinical symptoms including rest pain,intermittent claudication,local skin temperature and color,the pulsation recovery of dorsalis pedis artery and posterior tibial artery in affected limb of patients,ulcer healing of foot were obviously improved,with the total improvement rate being 92.44%.On 1 month after operation,the primary patency rate was 97.62%,and the two-stage patency rate was 100%,which was 85.37%,92.68%on 6 months after operation,63.64%,84.85%on 12 months after operation,and 46.15%,69.23%on 36 months after operation.The limb salvage rate on 1 month and 6 months after operation was 100%,which was 96.97%on 12 months after operation,and 92.31%on 36 months after operation.The limb salvage rate analysis(Kaplan Meier)showed that different gender,disease course and length of superficial femoral artery occlusion had a certain differences in limb salvage rates,especially among different disease course groups(P<0.05).Conclusion PTA in treatment of occlusion of superficial femoral artery long segment has satisfactory therapeutic effects and safety,which can obviously improve ABI of patients,therefor,which is worth using widely in clinical practice.