下肢动脉硬化闭塞症诊治进展概述

Progress in diagnosis and treatment of arteriosclerosis obliterans of the lower extremities

我国正步入人口老龄化社会,以下肢动脉硬化闭塞症为代表的周围动脉疾病发病率逐年升高,其诊治是一项迫切的系统工程。本文拟结合最新文献和单中心经验,对下肢动脉硬化闭塞症的诊治进展做一概述。在筛查诊断方面,流行病学资料提示国内在诊断和认识方面还存在明显不足。在基础用药方面,要重视阿司匹林和他汀类药物的基础治疗作用。在血管重建方面,我们要熟练掌握和合理运用开放、介入及杂交手术。在开放血管手术方面,我们仍需重视手术质量控制;在介入治疗方面,要及时关注减容技术、药物球囊技术、新型支架技术等治疗进展。杂交手术可综合前两者的优点,解决复杂临床情况,应用比例逐年增加。及时诊断,综合治疗,合理应用腔内、开放或杂交等血管重建技术,是下肢动脉硬化闭塞症治疗效果的重要保障。

The peripheral arterial disease is increasing in prevalence as population aging in China.The diagnosis and treatment of arteriosclerosis obliterans of the lower extremities is a complex project.Based on latest literatures and our own experience,we presented a brief review of the progress in diagnosis and treatment for the disease.Aspirin and statins are important basic medical therapy recommended by latest guidelines.Vascular surgeons should be skillful enough in surgical,endovascular and hybrid techniques.We must constantly be concerned about the latest development of new endovascular techniques,such as debulking techniques,drug coated balloons and new types of stents,etc.We also need to attach importance to quality control of open surgeries as always.Hybrid techniques might have advantages in treating complex multifocal lesions and were increasingly used nowadays.Timely diagnosis,comprehensive treatment and appropriate vascular reconstruction were very important for successful management of arteriosclerosis obliterans of the lower extremities.