血管腔内成形术治疗髂股动脉硬化闭塞症53例临床观察

Clinical observation of 53 cases of iliac femoral artery sclerosis occlusion with angioplasty

目的探讨血管腔内成形术治疗髂股动脉硬化闭塞症的临床疗效。方法选取2009年1月至2016年5月南京梅山医院收治的髂股动脉硬化闭塞患者53例,根据年龄将患者分为老年组和非老年组,两组患者均采用血管腔内成形术治疗。观察两组患者的手术成功率和术后不同时间段内髂股动脉的通畅率、手术后发生并发症的情况、进行手术治疗前后的踝肱指数变化情况、手术后病情复发情况;分析患者在手术后出现病情反复的独立影响因素。结果老年组的手术成功率低于非老年组,差异有统计学意义(P<0.05)。髂股动脉的通畅率随着随访时间的变长逐渐降低,但是老年组的通畅率降低情况明显高于非老年组,差异有统计学意义(P<0.05)。老年组的并发症明显高于非老年组,差异有统计学意义(P<0.05)。两组患者手术前的踝肱指数比较,差异无统计学意义(P>0.05);手术后老年组的踝肱指数明显低于非老年组,差异有统计学意义(P<0.05)。老年组患者的复发率明显高于非老年组,差异有统计学意义(P<0.05)。多因素分析结果显示,患者年龄、高血糖、原发性高血压是影响患者出现病情反复的独立影响因素(P<0.05)。结论老年患者因为自身各项生理器官功能的不断衰退,在手术效果及术后各项功能的恢复情况上都不及非老年患者,因此,老年患者在手术前后应该比非老年患者受到更加细致护理和关心。使用血管腔内成形术治疗髂股动脉硬化闭塞对患者造成的创伤更小,手术简单易操作,能够迅速将患者的患肢血管重建、改善患肢的供血和血液循环,且能有效降低患者的再狭窄率,减少患者手术后的复发率,临床疗效比较理想,值得进一步应用和推广。

Objectives To explore the clinical effect of angioplasty for the treatment of occlusion of iliac femoral artery.Methods Totally 53 patients with iliac femoral artery sclerosis occlusion were selected from January 2009 to May 2016 in Nanjing Meishan Hospital and they were divided into elderly group and non elderly group according to age.Patients in the two groups adopted intracavitary for treatment.Operation success rate,patency rate of the iliac artery at different time periods,postoperative complications,changes of ankle brachial index before and after operation and relapse of patients after operation between the two groups were observed and analyzed.The independent factors of the patient..s relapse after operation were analyzed.Results Surgical success rate was significantly lower in elderly group than that in non elderly group(P < 0.05).Iliac arterial patency rate gradually reduced as the follow-up duration extended,but reduction of iliac arterial patency rate in elderly group was more obviously than that of non elderly group (P < 0.05).Complications of elderly group was obviously higher than that of non elderly group(P < 0.05).Ankle brachial index has no obvious difference between the two groups before operation(P > 0.05),but it was significantly lower in elderly group than that in non elderly group postoperation(P < 0.05).Recurrence rate of elderly group was obviously higher than that of non elderly group(P < 0.05).Multi-factor analysis results showed that the patients'age,high blood glucose,high blood pressure were the independent impact factors influencing a patient repeatedly(P < 0.05).Conclusions Elderly patients because of its various physiological organ function,the effect of surgery and postoperative functions on the recovery of all are less than those of older patients,therefore,elderly patients before and after the surgery should be taken more meticulous care and concern than older patient.Using angioplasty to treat iliac femoral artery sclerosis occlusion in patients is with smaller trauma,and the operation is simple and easy to operate.It can quickly revascularizate the affected limbs,improve blood flow and limb blood circulation of the affected limbs,effectively reduce the rate of restenosis and recurrence rate after surgery with ideal clinical curative effect.It is worth application and popularization.