内膜剥脱术治疗下肢血栓闭塞型脉管炎的效果观察

Effect of endarterectomy in the treatment of lower extremity thromboangiitis obliterans

目的观察内膜剥脱术治疗下肢血栓闭塞型脉管炎(TAO)的临床疗效.方法回顾性分析2017年1月至2018年3月南澳医院收治的TAO患者资料,选取47例采取球囊扩张和(或)置管溶栓术治疗的患者纳入介入组;选取47例采取内膜剥脱术治疗的患者纳入剥脱组;术后7d比较两组患者视觉模拟评分(VAS),统计两组患者临床症状改善时间,术后6个月观察两组患者间歇性跛行距离与患肢踝肱指数(ABI),统计两组术后并发症发生率.结果术后7d,两组VAS评分均较本组术前好转,且剥脱组低于介入组;剥脱组患者皮肤颜色改善时间、皮肤温度改善时间和足溃疡愈合时间均短于介入组;术后6个月,两组患者间歇性跛行距离和ABI均较本组术前好转,且剥脱组均优于介入组;术后12个月中,剥脱组继发血栓发生率为4.26%低于介入组19.15%,差异有统计学意义(P<0.05).结论内膜剥脱术治疗下肢血栓闭塞型脉管炎疗效理想,可尽快缓解患者临床症状.

Objective To observe the clinical effect of endarterectomy in the treatment of lower extremity thromboangiitis obliterans(TAO). Method The data of TAO patients admitted to Nan’ao Hospital from January 2017 to March 2018 were retrospectively analyzed. 47 patients treated with balloon dilatation and/or catheterization were selected as intervention group;47 patients treated with endometriosis were selected as stripping group;visual analogue scale(VAS) was compared between the two groups 7 days after operation. The improvement time of clinical symptoms was counted. The interval claudication distance and ankle brachial index(ABI) were observed 6 months after operation. The incidence of complications was counted 12 months after operation. Result On the 7 days after operation, the VAS scores of the two groups were better than those of the preoperative group, and the stripping group was lower than that of the interventional group;the skin color improvement time, skin temperature improvement time and foot ulcer healing time of the stripping group were shorter than those of the interventional group;6 months after operation, the intermittent claudication distance and ABI of the two groups were better than those of the preoperative group, and the stripping group was better than that of the interventional group;In 12 months after operation, the incidence of secondary thrombosis in stripping group was 4.26%, which was lower than that in interventional group 19.15%(P < 0.05). Conclusion Endarterectomy is an ideal treatment for lower extremity thromboangiitis obliterans, which can relieve the clinical symptoms of patients as soon as possible.