摘要
目的 :评估依据腹主动脉与肾动脉解剖关系制定肾动脉支架操作技术策略对介入手术的影响。方法:回顾性分析2012-01至2013-12在阜外医院接受肾动脉介入治疗的单侧粥样硬化性肾动脉狭窄患者182例。根据肾下腹主动脉与肾动脉开口的不同成角分为3组:即91~120°者为A组(n=20);61~90°者为B组(n=125);30~60°者为C组(n=37);根据腹主动脉不同形态[肾下腹主动脉和(或)髂动脉是否迂曲]分为非迂曲型组(n=146)和迂曲型组(n=36)。评估不同组别间支架到位采用的操作技术(即技术1为单纯导丝锚定;技术2为导丝锚定+球囊杆辅助;技术3为导丝+球囊共同锚定)、更换上肢动脉入径比例(桡动脉或肱动脉路径)、X线曝光时间、手术操作时间、对比剂用量和手术相关并发症等方面的区别。结果 :C组患者分别与A、B组比较,使用操作技术(2+3)的比例(100.0%vs 20.0%、31.2%)、更换上肢动脉入径比例(10.8%vs 0.0%、1.6%)、X线曝光时间[(9.2±3.8)min vs(5.2±3.1)min、(5.3±2.8)min]、手术操作时间[(27.4±6.5)min vs(18.6±5.7)min、(20.5±6.1)min]、对比剂用量[(59.3±8.4)ml vs(44.8±7.2)ml、(48.4±7.3)ml]和手术相关并发症总计发生率(8.1%vs 0.0%、0.8%)均增加(P均<0.05),而B组与A组的各项指标比较,差异均无统计学意义。迂曲型组与非迂曲型组比较,使用操作技术(2+3)的比例(72.2%vs 11.6%)、更改上肢动脉入径比例(11.1%vs 1.4%)、X线曝光时间、手术操作时间、对比剂用量和手术相关并发症总计发生率(8.3%vs 0.7%)均增加(P均<0.05)。结论:在肾动脉介入治疗中,肾动脉开口明显向上和肾下腹主动脉迂曲均会增加手术的操作难度及并发症发生风险。
Objective： To evaluate the impact of renal artery stenting techniques upon anatomical correlation of abdominal aorta and renal artery.Methods： A total of 182 patients with unilateral atherosclerotic renal stenosis and received renal artery stenting in our hospital from 2012-01 to 2013-12 were retrospective studied. Based on the angle of infrarenal abdominal aorta and renal artery, the patients were divided into 3 groups： Group A（91-120）°, n=20, Group B（61-90）°, n=125 and Group C,（30-60）°, n=37. According to the tortuosity of infrarenal abdominal aorta and/or iliac artery, the patients were divided into 2 groups： Non-tortuosity group, n=146 and Tortuosity group, n=36. Operative techniques included in（1） wire anchoring alone,（2） wire anchoring＋balloon rod assisting and（3） anchoring with wire and balloon. The ratio of upper extremity artery approaching（brachial or radial artery）, X-ray exposure time, operation time, contrast dosage and relevant complications were compared among different groups upon stent placing.Results： Compared with Group A and Group B, the following parameters were increased in Group C： ratios for usingtechnique（2） ＋（3）（100.0% vs 20.0%, 31.2%）, for extremity artery approaching（10.8% vs 0.0%, 1.6%）; X-ray exposure time（9.2±3.8） min vs（5.2±3.1） min,（5.3±2.8） min, operation time（27.4±6.5） min vs（18.6±5.7） min,（20.5±6.1） min; contrast dosage（59.3±8.4） ml vs（44.8±7.2） ml,（48.4±7.3） ml and the incidences of relevant complications（8.1% vs 0.0%, 0.8%）, all P〈0.05. The above parameter were similar between Group A and Group B. Compared with Non-tortuosity group, the following parameters were elevated in Tortuosity group： ratios for using technique（2） ＋（3）（72.2% vs 11.6%）, for extremity artery approaching（11.1% vs 1.4%）, the total incidences of X-ray exposure time, operation time, contrast dosage and relevant complications（8.3% vs 0.7%）, all P〈0.05.Conclusion： The ac
作者
刘杰
董徽
车武强
邹玉宝
蒋雄京
LIU Jie;DONG Hui;CHE Wu-qiang;ZOU Yu-bao;JIANG Xiong-jing(Department of Cardiology, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing （100037）, China)
出处
《中国循环杂志》
CSCD
北大核心
2018年第2期148-151,共4页
Chinese Circulation Journal
关键词
肾动脉狭窄
血管成形术
经皮
经腔
肾动脉开口位置
Renal artery stenosis
Angioplasty, percutaneous, transluminal
Renal artery opening position
