经皮血管内支架治疗老年下肢动脉硬化闭塞症的疗效

Therapeutic effect of percutaneous transvascular stent on senile lower extremity arteriosclerosis obliterans

目的分析老年下肢动脉硬化闭塞症患者采取经皮血管内支架治疗的疗效。方法回顾性分析深圳市中医院放射介入科2014年7月至2018年1月收治的46例老年下肢动脉硬化闭塞症患者,随机分为对照组与观察组,每组23例。经皮血管内球囊扩张术为对照组,经皮血管内球囊扩张术及支架治疗为观察组。对比两组患者临床治疗效果、并发症,随访6 、12个月踝肱指数与跛行距离。结果观察组患者临床有效率(95.65%)与对照组(73.91%)比较,差异有统计学意义(P<0.05);观察组患者并发症发生率(4.35%)与对照组(26.09%)比较,差异有统计学意义(P<0.05)。两组患者随访6 、12个月,踝肱指数与跛行距离随着术后时间的延长改善明显,且观察组患者踝肱指数、跛行距离高于对照组,差异有统计学意义(P<0.01)。结论采取经皮血管内球囊扩张术联合血管内支架治疗老年下肢动脉硬化闭塞症,可有效提高临床治疗效果,降低术后并发症的发生,提高手术后踝肱指数,改善延长跛行距离,效果理想。

Objective To observe the curative effect of percutaneous transvascular stenting on elderly patients with lower extremity arteriosclerosis obliterans. Methods A retrospective analysis of 46 patients with lower extremity arteriosclerosis obliterans admitted to Shenzhen Hospital of Traditional Chinese Medicine from July 2014 to January 2018 was made. The patients were randomly divided into control group and observation group, with 23 cases in each group. Percutaneous balloon angioplasty was used in the control group, and percutaneous balloon angioplasty and stenting were used in the observation group. The clinical effects and complications of the two groups were compared. And the ankle brachial index and claudication distance were compared, when the patients had been followed up for 6 months and 12 months. Results The clinical effective rate of the observation group (95.65%) was higher than that of the control group (73.91%), and the difference was significant(P<0.05). The incidence of complications in the observation group (4.35%) was lower than that in the control group (26.09%), and the difference was significant (P<0.05). The sputum index and the sacral distance 6 months and 12 months after treatment in the two groups were significantly improved with the prolongation of the postoperative time. The sputum index and the claudication distance of the observation group were significantly higher than the control group, and the difference was significant (P<0.01). Conclusions In elderly patients with lower extremity arteriosclerosis obliterans, percutaneous balloon angioplasty combined with endovascular stenting can effectively improve the clinical treatment effect, reduce the incidence of postoperative complications, and improve the postoperative index and claudication distance with ideal effects.