保守治疗在慢性股浅动脉硬化闭塞症治疗中的临床意义

Clinical significance of conservative treatment for chronic superficial femoral arteriosclerosis obliterans

目的探讨保守治疗在慢性股浅动脉硬化症治疗中的临床意义。方法收集2014年6月至2017年6月山东第一医科大学第一附属医院(山东省千佛山医院)收治的112例慢性股浅动脉硬化闭塞症患者临床资料,根据治疗方式的不同将患者分为保守组(n=47)和介入组(n=65),比较两组患者出院前、出院后1年及出院后3年的临床疗效。结果出院前,介入组患者的踝肱指数(ABI)增加值、总有效率均高于保守组患者,单侧肢体治疗费用均多于保守组患者(P<0.05)。介入组患者住院期间的并发症发生率为10.77%,高于保守组的8.51%(P<0.05)。出院后1年,介入组患者的ABI增加值高于保守组患者(P<0.05);两组患者的总有效率、并发症发生情况、病变动脉再狭窄率比较,差异均无统计学意义(P>0.05)。出院后3年,两组患者的ABI增加值、总有效率、并发症发生情况比较,差异均无统计学意义(P>0.05);保守组患者的病变动脉重建后再狭窄率、再次干预率均低于介入组患者,差异均有统计学意义(P<0.05)。结论保守治疗经济、安全、有效,可能是慢性股浅动脉硬化闭塞症的首选治疗方式。

Objective To investigate the clinical significance of conservative treatment for chronic superficial femoral arteriosclerosis obliterans.Method The clinical data of 112 patients with chronic superficial femoral arteriosclerosis obliterans who were admitted to the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital)from June 2014 to June 2017 were collected.According to different treatment methods,patients were divided into the conservative group(n=47)and the interventional group(n=65).The clinical efficacy of the two groups of patients before discharge,1 year after discharge,and 3 years after discharge were compared.Result Before discharge,the ankle brachial index(ABI)added value and total response rate of the interventional group were higher than those of the conservative group,and the cost of unilateral limb treatment was more than that of the conservative group(P<0.05).The incidence of complications in the interventional group was 10.77%,which was higher than 8.51%in the conservative group(P<0.05).One year after discharge,the ABI added value of the interventional group was higher than that of the conservative group(P<0.05);the total response rate,complications,and restenosis rate of the diseased artery between the two groups were not statistically significant(P>0.05).Three years after discharge,there was no significant difference in the ABI added value,total effective rate,and complications of the two groups of patients(P>0.05);the restenosis rate and re-intervention rate of patients in the conservative group were lower than those in the intervention group after reconstruction of the diseased artery,and the differences were statistically significant(P<0.05).Conclusion It is economical,safe,and effective to take conservative treatment,which could be considered as the first choice for patients with chronic superficial femoral arteriosclerosis obliterans.