联合治疗对下肢动脉硬化闭塞症的疗效

Efficacy of combined therapy for lower extremity arteriosclerosis obliterans

目的探讨经动脉旁路转流术与腔内介入联合治疗下肢动脉硬化闭塞症的效果。方法将97例下肢动脉硬化闭塞症患者采用随机数字表法分为两组,对照组48例给予腔内介入治疗,观察组49例在对照组治疗的基础上联合动脉旁路转流术,比较两组血管通畅、跛行距离、踝肱指数(ABI)、截肢率、腘动脉及胫动脉血流情况及并发症。结果观察组半年末跛行距离明显远于对照组,ABI明显高于对照组,胫动脉、腘动脉血液流速均快于对照组(P<0.05);两组血管通畅率、并发症发生率和截肢率比较,P>0.05。结论腔内介入治疗下肢动脉硬化闭塞症基础上结合动脉旁路转流术,可改善患者腘、胫动脉血流及跛行距离,提高保肢率和血管通畅率,且安全性高。

Objective To explore the efficacy of transarterial bypass and intracavitary intervention in the treatment of arteriosclerosis obliterans of lower extremities.Methods 97 patients with lower extremity arteriosclerosis obliterans were randomly divided into two groups.48 cases in the control group received intracavitary intervention,49 cases in the observation group were combined with intracavitary intervention on the basis of the control group.The vascular patency,claudication distance,ankle brachial index(ABI),amputation rate,blood flow rate of popliteal artery and tibial artery and complications were compared between the two groups.Results The claudication distance at the end of six months in the observation group was significantly longer than that in the control group;ABI was significantly higher than that in the control group;blood flow rate of the tibial artery and popliteal artery were significantly faster than those in the control group(P<0.05).There was no significant difference in vascular patency rate and incidence of complications and amputation rate between the two groups(P>0.05).Conclusion Intracavitary interventional combined with transarterial bypass can significantly improve the blood flow rate of popliteal artery and tibial artery and claudication distance,increase the rate of limb salvage and vascular patency with high safety in the treatment of lower extremity arteriosclerosis obliterans.