摘要
[目的]比较介入治疗联合胫骨横向搬移与单纯介入手术治疗下肢缺血性疾病,包括血栓闭塞性脉管炎(TAO)、动脉硬化闭塞症(TSO)的临床效果。[方法]回顾性分析本院2015年4月～2017年4月收治的42例42肢下肢缺血性疾病患者,其中,介入-骨搬移组22例,应用介入治疗解决近端血管阻塞问题后采用胫骨横向搬移治疗;单纯介入组20例采用单纯介入治疗。采用视觉模拟疼痛评分(VAS)和生活质量综合评估(SF36)评价临床效果,测量第1足趾皮温、并行下肢血管CTA检查。[结果]两组患者均顺利手术,术中无严重并发症。两组术后随访时间12～23个月。虽然入院时、术后1个月两组间VAS评分、第1足趾皮温和SF36评分的差异无统计学意义(P>0.05),但术后3、12个月时,介入-骨搬移组VAS评分显著低于单纯介入组,介入-骨搬移组第1足趾皮温显著高于单纯介入组,介入-骨搬移组SF36评分和生理机能(PF)、生理职能(RP)、躯体疼痛(BP)、健康状况(GH)亚评分显著优于单纯介入组,差异均有统计学意义(P<0.05)。下肢动脉CTA显示介入-骨搬移组于术后3个月可见明显侧枝血管网形成,显著优于单纯介入组。[结论]介入治疗联合胫骨横向搬移可以重建下肢缺血性疾病患者远端肢体侧枝循环,远期疗效优于单纯介入治疗,可以更好地改善患者症状,提高生活质量。
[Objective] To compare the clinical outcomes of interventional therapy combined with transverse tibial bone transport versus interventional surgery only for lower extremity ischemic diseases including thromboangiitis obliterans(TAO)nd arteriosclerosis obliterans(ASO).[Methods] A retrospective study was conducted on 42 patients( 42 limbs) with ischemic diseases of the lower extremities between April 2015 and April 2017. Of them, 22 patients underwent interventional therapy followed by transverse tibial bone transport(the IT-TT group), while the remaining 20 patients received interventional therapy only(the IT group). The visual analogue scale(VAS) for pain and Short Form Health Survey(SF-36) were used for evaluation of the clinical outcomes, additionally the skin temperature of the first toe was measured and computed tomography angiography(CTA) of the lower extremity arteries was conducted.[Results] All the patients had operation conducted smoothly without serious complications in anyone of them. The follow-up lasted for 12~23 months. Although no statistically significant differences were proved between the two groups regarding to VAS, skin temperature of the first toe and SF36 scores before operation and at1 month postoperatively, the IT-TT group had significantly less VAS score, significantly higher skin temperature of the first toe,and significantly greater subscores of SF36 score, including physical functioning(PF), physical role functioning(RP), bodily pain(BP) and general health perception(GH) than the IT group at 3 and 12 months postoperatively, which all were statistically significant(P<0.05). The CTA of lower limb arteries at 3 months postoperatively revealed that the remarkable collateral circulation recreated in the IT-TT group, which was significantly superior to that in the IT group.[Conclusion] Interventional therapy combined with transverse tibial transport does effectively reconstruct the collateral circulation of the ischemic distal limb, relief the symptoms and improve the quality of life, which
作者
赵威
鲁志超
王新栋
杨茂伟
ZHAO Wei;LU Zhi-chao;WANG Xin-dong;YANG Mao-wei(Department of Orthopedics, The First Hospital, China Medical University,Shenyang 110001, China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第9期809-814,共6页
Orthopedic Journal of China
