介入治疗在下肢动脉硬化闭塞症中的应用价值

Application value of interventional therapy in lower extremity arteriosclerosis obliterans

目的探讨介入治疗在下肢动脉硬化闭塞症中的应用价值。方法选择我院2016年11月~2018年10月收治的下肢动脉硬化闭塞症患者60例,随机分为观察组和对照组,每组30例,两组均采取药物治疗,其中观察组同时联合介入治疗。治疗后对比分析两组的临床疗效、治疗前后足背动脉和胫动脉踝肱指数的变化情况及治疗后的不良反应及并发症发生率。结果观察组患者治疗后的总有效率为93.33%、显著高于对照组(P<0.05)。观察组和对照组患者的足背动脉和胫动脉治疗后的踝肱指数分别显著高于治疗前。且观察组患者的足背动脉和胫动脉治疗后的踝肱指数分别为(0.95±0.22)、(0.99±0.17),分别显著高于对照组(P<0.05)。观察组患者联合介入治疗后出现过敏反应1例、血小板减少1例、穿刺部位血肿5例、假性动脉瘤3例、下肢过度灌注综合征1例、支架内急性闭塞1例,其治疗后的不良反应及并发症发生率合计达40.0%,显著高于对照组,两组比较差异具有显著性(P<0.05)。结论介入治疗用于下肢动脉硬化闭塞症的治疗是一种更安全、有效的治疗方法,能显著提高临床疗效、且改善临床症状,但存在穿刺部位血肿、假性动脉瘤、下肢过度灌注综合征、支架内急性闭塞等并发症。

Objective To explore the application value of interventional therapy in lower extremity arteriosclerosis obliterans.Methods Sixty patients with lower extremity arteriosclerosis obliterans admitted to our hospital from November 2016 to October 2018 were randomly divided into observation group and control group,30 cases in each group.The two groups were treated with drugs,and the observation group was combined with interventional therapy.After treatment,the clinical efficacy,changes of the ankle-brachial index of foot dorsal artery and tibial artery,and adverse reactions and complications after treatment were compared.Results The total effective rate of the observation group after treatment was 93.33%,which was significantly higher than that of the control group(P<0.05).The anklebrachial index after treatment of the foot dorsal artery and tibial artery in the observation group and the control group were significantly higher than those before treatment,which were(0.95±0.22)and(0.99±0.17),respectively,in the observation group after treatment,significantly higher than those of the control group(P<0.05).One case of allergic reaction occurred in the observation group,as well as 1 case of thrombocytopenia,5 cases of hematoma at the puncture site,3 cases of pseudoaneurysm,1 case of lower extremity hyperperfusion syndrome,and 1 case of acute occlusion in the stent.The adverse reactions and complications rate was 40.0%in the observation group,significantly higher than that in the control group,and the difference between the two groups was significant(P<0.05).Conclusion Interventional therapy is a safer and more effective treatment for lower extremity arteriosclerosis obliterans.It can significantly improve clinical efficacy and improve clinical symptoms,but there are complications such as hematoma at the puncture site,pseudoaneurysm,lower extremity hyperperfusion syndrome,and acute occlusion in the stent.