动脉取栓与介入溶栓治疗急性下肢动脉栓塞的疗效、安全性比较

Comparison of efficacy and safety between arterial thrombectomy and interventional thrombolysis in the treatment of acute lower extremity arterial embolism

目的探讨动脉取栓与介入溶栓治疗急性下肢动脉栓塞的疗效、安全性。方法收集2018年2月至2021年11月张家口市第一医院收治的110例急性下肢动脉栓塞患者的临床资料,根据治疗方法的不同将其分为取栓组(n=51,采用动脉取栓治疗)和溶栓组(n=59,采用介入溶栓治疗)。比较两组患者的临床疗效、血栓清除情况、踝肱指数及并发症发生情况。结果取栓组患者总有效率为94.1%,高于溶栓组患者的81.4%,差异有统计学意义(P<0.05)。取栓组患者的血栓完全清除率、总清除率分别为54.9%、100%,均高于溶栓组患者的35.6%、84.7%,差异均有统计学意义(P<0.05)。两组患者手术前后的踝肱指数比较,差异均无统计学意义(P>0.05)。取栓组患者并发症总发生率为3.9%,低于溶栓组患者的15.3%,差异有统计学意义(P<0.05)。结论动脉取栓的临床疗效与安全性略优于介入溶栓,临床治疗中可根据患者的具体情况选择合适的手术方式。

Objective To investigate the efficacy and safety of arterial thrombectomy and interventional thrombolysis in the treatment of acute lower extremity arterial embolism.Method The clinical data of 110 patients with acute lower extremity arterial embolisms admitted to the First Hospital of Zhangjiakou City from February 2018 to November 2021 were collected.They were divided into thrombectomy group(n=51,treated with arterial thrombectomy)and thrombolysis group(n=59,treated with interventional thrombolysis)according to different treatment methods.The clinical curative effect,thrombus clearance,ankle-brachial index,and complications were compared between the two groups.Result The total effective rate of thrombectomy group was 94.1%,higher than 81.4%in the thrombolysis group,the difference was statistically significant(P<0.05).The complete clearance rate and total clearance rate of thrombus in the thrombectomy group were 54.9%and 100%,respectively,which were higher than those in the thrombolysis group whose value was 35.6%and 84.7%,the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the ankle-brachial index before and after treatment between the two groups(P>0.05).The total incidence rate of complications in the thrombectomy group was 3.9%,which was lower than 15.3%in the thrombolysis group,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy and safety of arterial thrombectomy is slightly better than that of interventional thrombolysis.In clinical treatment,appropriate surgical methods can be selected according to the specific conditions of patients.