两点入路腔内修复术在周围动脉完全断裂治疗中的应用

Endovascular repair via two-point approach in the treatment of complete rupture of peripheral arteries

目的探讨同时创建两点入路腔内修复术治疗急性周围动脉完全断裂的临床效果。方法回顾性分析2010年1月至2018年2月解放军第九六〇医院收治的18例急性周围动脉完全断裂患者临床资料。根据手术入路不同,将患者分为常规腔内修复术组(A组,n=10)和改良两点入路腔内修复术组(B组,n=8)。对比两组手术成功率、手术时间、术中出血量、术后住院时间、术后并发症及随访结果。结果两组手术均顺利完成。A组、B组手术时间分别为平均(58.5±7.2) min、(33.9±3.9) min(P=0.020),术中出血量分别为平均(216.0±109.2) mL、(110.6±51.0) m L(P=0.011),B组均显著低于A组。两组术后住院时间、术后并发症及随访结果差异,均无统计学意义(P>0.05)。结论同时创建两点入路腔内修复术,可进一步缩短腔内技术修复周围动脉完全断裂损伤的时间,并降低术中出血量。

Objective To discuss the clinical effect of endovascular surgery via two-point approach in treating acute complete rupture of peripheral arteries. Methods The clinical data of 18 patients with acute complete rupture of peripheral artery,who were admitted to the No.960 Hospital of PLA of China during the period from January 2010 to February 2018 to receive treatment,were retrospectively analyzed. According to the surgical approach,the patients were divided into group A(receiving conventional endovascular repair,n=10) and group B(endovascular repair with modified two-point approach technique,n=8). The success rate of surgery,the time spent for operation,the amount of intraoperative blood loss,the postoperative hospitalization days,the postoperative complications and the follow-up results were compared between the two groups. Results Successful operation was accomplished in all 18 patients. In group A and group B,the mean time spent for operation was(58.5±7.2) min and(33.9±3.9) min respectively(P=0.020),and the mean amount of intraoperative blood loss was(216.0±109.2) m L and(110.6±51.0) m L respectively(P=0.011);both the time spent for operation and the amount of intraoperative blood loss in group B were significantly lower than those in group A. No statistically significant differences in the postoperative hospitalization days,the postoperative complications and the follow-up results existed between the two groups(P>0.05). Conclusion In the treatment of acute complete rupture of peripheral artery,endovascular repair with two-point approach technique can further shorten the time spent for operation and reduce the amount of intraoperative blood loss.(J Intervent Radiol,2021,30: 62-65)