经皮腔内支架成形术和动脉内膜剥脱术治疗下肢动脉硬化闭塞症的对比研究

A comparative study of percutaneous transluminal angioplasty and stenting versus endarterectomy in treatment of lower extremity atherosclerotic occlusive disease

目的比较经皮腔内支架成形术和动脉内膜剥脱术治疗下肢动脉硬化闭塞症的效果。方法回顾性分析2018年1月至2021年1月河南科技大学第一附属医院下肢动脉硬化闭塞症患者85例,将2018年1月至2019年11月采用动脉内膜剥脱术治疗的25例患者作为对照组,将2019年12月至2021年1月采用经皮腔内支架成形术治疗的60例患者作为研究组。对比两组术前、术后1个月、术后3个月足背血流动力学(足背动脉内径、血流峰速)、踝肱指数(ABI)、跛行距离。结果术后1个月、术后3个月两组足背动脉内径、血流峰速均较术前改善,差异有统计学意义(P<0.05),但两组足背动脉内径、血流峰速组间比较,差异未见统计学意义(P>0.05)。术后1个月、术后3个月,两组ABI指数均较治疗前增高,且研究组高于对照组,差异有统计学意义(P<0.05)。术后1个月、术后3个月两组跛行距离均较术前增加,研究组长于对照组,差异有统计学意义(P<0.05)。结论与动脉内膜剥脱术比较,采用经皮腔内支架成形术治疗下肢动脉硬化闭塞症患者可改善足背血流动力学和ABI指数,延长跛行距离、提高运动功能。

Objective To compare the effects of percutaneous transluminal angioplasty and stenting and endarterectomy on lower extremity atherosclerotic occlusive disease.Methods Eighty-five patients with lower extremity atherosclerotic occlusive disease in the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to January 2021 were retrospectively analyzed.Twenty-five patients treated with endarterectomy from January 2018 to November 2019 were selected as the control group.Sixty patients treated with percutaneous endostenting from December 2019 to January2021 were selected as the experimental group.The dorsal foot hemodynamics(dorsal foot artery diameter,blood flow peak velocity),ankle-brachial index(ABI)and claudication distance were compared between the two groups before,1 month and 3 months after surgery.Results The inner diameter and blood flow peak velocity of dorsal foot artery of the two groups were improved at 1 month and3 months after surgery,and the differences were significant(P<0.05),but there were no significant differences between the two groups(P>0.05).ABI levels were higher in both groups at 1 month and 3 months after surgery than before,and that of the study group was higher than that of the control group,the differences were significant(P<0.05).The claudication distances in the two group were longer at 1 and 3 months than that before surgery,and the claudication distance in the study group was longer than that in the control group at 1 and 3 months after surgery,and the differences were significant(P<0.05).Conclusions Compared with endarterectomy,percutaneous transluminal angioplasty and stenting for patients with lower extremity atherosclerotic occlusive disease can improve dorsalis hemodynamics and ABI index,prolong claudication distance,and improve motor function.