摘要
目的评价下肢动脉缺血性疾病的血管造影诊断价值及介入治疗效果。方法对75例下肢动脉缺血性疾病患者行下肢动脉血管造影检查,并对检查结果进行评估,测量狭窄段血管的长度及狭窄率,将其中同意行介入治疗的30例患者(39条患肢)纳入介入治疗组,治疗使用球囊导管进行扩张,对下肢动脉严重狭窄者行自膨式支架置入术。将拒绝行介入治疗的45例患者(60条患肢)纳入保守治疗组,采用内科保守药物治疗。临床随访6~36个月,观察术中血管再通及治疗后患者下肢缺血症状改善情况。对介入治疗组和保守治疗组临床疗效进行比较。结果介入治疗组技术成功率为100%,临床有效率为90.0%,1年内发生再狭窄而导致截肢率为10.0%;保守治疗组临床有效率为62.2%,截肢率为37.8%,两组间差异有统计学意义(P<0.05)。介入治疗组3年开通率为57.7%,截肢率为23.1%。结论介入治疗下肢动脉缺血性疾病可明显改善患者临床症状,提高临床有效率,是治疗下肢动脉缺血性疾病的有效方法。
Objective To assess the value of angiography in diagnosing lower limb ischemic diseases and to discuss the therapeutic results of interventional therapy for lower limb ischemic diseases. Methods Lower limb artery DSA was performed in 75 patients with lower limb ischemic diseases. The angiographie findings were evaluated, and both the length and the stenotic rate of the diseased vessels were measured. Thirty of the total 75 patients, with 39 diseased lower limbs, agreed to receive interventional therapy (study group). Percutaneous balloon dilation was employed in the patients of study group, and self-expandable stent placement was carried out for patients with severe arterial stenosis. The remaining 45 patients who refused to accept interventional treatment (total of 60 lower limbs with symptomatic ischemia) were treated with internal conservative measures (control group). Clinical follow-up for 6 to 36 months was made. Observations on the arterial reopen and the improvement of ischemic symptoms were carefully taken. The results were compared between the two groups. Results The technical success rate and the clinical effective rate of the study group were 100% and 90.0%, respectively. The one-year amputation rate was 10.0%. The clinical effective rate and the one-year amputation rate of the control group were 62.2% and 37.8%, respectively. The difference in clinical effective rate between the two groups was statistically significant (P 〈 0.05). The 3-year patency rate and amputation rate in the study group were 57.7% and 23.1%, respectively. Conclusion Interventional treatment can markedly improve the clinical symptoms of lower limb ischemic diseases and increase the clinical effective rate. Therefore, this technique is an effective therapy for lower limb ischemic diseases.
出处
《介入放射学杂志》
CSCD
北大核心
2012年第2期111-114,共4页
Journal of Interventional Radiology
关键词
下肢动脉缺血疾病
血管造影
介入治疗
lower limb isehemie disease
angiography
interventional therapy