摘要
目的评价锁骨下动脉粥样硬化性病变介入治疗的长期疗效。方法对2003年3月至2011年6月沈阳军区总医院心血管内科诊治的72例锁骨下动脉狭窄或闭塞患者，实施经皮腔内血管成形术与支架植入术治疗，随访观察介入治疗后1年以上的临床疗效。结果72例患者中男性61例（84．7％），年龄（64．9±9．0）岁，吸烟史48例（66．7％），原发性高血压病史34例（47．2％），糖尿病史22例（30．6％）。术前临床表现肢体供血不足62例（86．1％）、椎基底供血不足27例（37．5％）、有血管杂音24例（33．3％）、血管搏动减弱或消失72例（100％）。介入手术成功66例（91．7％），失败6例（8．3％）。随访36（12～100）个月，随访率97．2％。上述四个方面临床治愈好转率分别为91．9％、88．9％、91．7％、93．1％，恶化病例1例，为介入治疗失败患者行外科人工血管置换术。介入成功患者患侧术后收缩压较其术前明显升高，差异有统计学意义[（115．00±21．21）mmHg vs.（82．92±51．01）mmHg，P〈0．05，1mmHg=0．133kPa]。结论经皮血管腔内介入治疗锁骨下动脉病变安全、有效，长期疗效明确。
Objectives To evaluate the long-term effect of intervention therapy for the subclavian artery. Methods Totally72 patients with subclavian artery stenosis or occlusion were admitted to General Hospital of Shenyang Military Region from March 2003 to June 2011 and were carried out intervention therapy. Results of clinical follow-up and image performance more than 1 year after intervention therapy were reviewed. Results Of the 72 patients, 61 （84.7%） were male and the average age was （64.9 ± 9.0） years old. Among the 72 patients, 48 （66.7%） had a history of smoking, 34 （47.2%） had a history of hypertension, and 22 （30.6%） had a history of diabetes. Preoperative symptoms of limb blood supply were observed in 62 patients （86.1%）, vertebrobasilar insufficiency in 27 patients （37.5%）, vascular murmur in 24 patients （33.3%） and vascular pulse weakened or disappeared in 72 patients （100%）. Totally 66 patients succeed in intervention therapy and the success rate was 91.7%, while 6 patients （8.3%） failed. Mean follow-up duration was 36 months （ranged from 12 to 100 months） and follow-up rate was 97.2%. The clinical cure rates of the above four aspects were 91.9%, 88.9%, 91.7% and 93.1%. One case deteriorated, who underwent surgical graft replacement after intervention treatment failure. Ipsilateral average systolic blood pressure of patients after successful intervention therapy was significantly higher [（115.00±21.21） mmHgvs.（82.92±51.01） mmHg, P〈0.05, 1 mmHg=0.133 kPa]. Conclusions Pereutaneousendovascular intervention treatment for subclavian artery disease is clear in safety, effectiveness and long-term efficacy.
出处
《岭南心血管病杂志》
2013年第6期661-663,667,共4页
South China Journal of Cardiovascular Diseases
