摘要
目的探讨个性化的杂交手术方式在复杂性下肢动脉硬化闭塞症(LEASO)治疗中的应用价值。方法回顾性分析蚌埠医学院第一附属医院血管外科2016年7月—2018年9月26例复杂性多节段LEASO患者的临床资料。其中男17例、女9例,年龄45~88(66.4±10.8)岁。采用个性化腔内联合开放手术的杂交手术方式进行治疗,观察术前、术后踝肱指数(ABI)、间歇性跛行距离及一期通畅率等情况。结果 26例患者手术成功率100%,术中、术后未出现严重并发症,术后下肢缺血症状改善。出院时:术后患肢ABI升至0.89±0.14,明显高于手术前的0.41±0.46,差异有统计学意义(t=5.151,P<0.05);间歇性跛行距离(523±56)m,明显长于手术前的(132±46)m,差异有统计学意义(t=4.982,P<0.05)。26例患者术后随访12个月,术后6个月一期通畅率为92.30%(24/26),患肢保肢率为100%(26/26),患者生存率100%(26/26);术后12个月一期通畅率为76.92%(20/26),保肢率为92.30%(24/26),患者生存率为100%(26/26)。结论对于累及多节段的复杂性LEASO,采用个性化的杂交手术方式是安全有效的,患者获益更多。
Objective This study aimed to explore the application value of personalized hybridization in the treatment of complex lower extremity arteriosclerosis obliterans(LEASO).Methods Retrospective analysis was performed on the clinical data of 26 patients with complex multi-segmental LEASO at the Vascular Surgery Department of the First Affiliated Hospital of Bengbu Medical College from July 2016 to September 2018.A total of 17 males and 9 females,aged between 45 and 88(66.4±10.8)years,were included in this study.Ankle brachial index(ABI),intermittent claudication distance,and primary patency rate were observed.Results The success rate of hybrid surgery was 100%in 26 patients,no serious complications occurred during and after the operation,symptoms of lower limb ischemia were improved,and the examination of postoperative ABI was significantly improved compared with that before the operation.The average ABI of the affected limbs increased to 0.89±0.14,which was significantly higher than 0.41±0.46 before the operation,with statistically significant difference(t=5.151,P<0.05).The distance of intermittent claudication was(523±56)m,which was significantly longer than(132±46)m before the operation,and the difference was statistically significant(t=4.982,P<0.05).All 26 patients were followed up for 12 months.The primary patency rate was 92.30%(24/26),the limb salvage rate was 100%(26/26),and the survival rate was 100%(26/26).The primary patency rate was 76.92%(20/26),the limb salvage rate was 92.30%(24/26),and the survival rate was 100%(26/26).Conclusions For complex LEASO involving multiple segments,individualized hybrid surgical approach is safe and effective with increased patient benefit.
作者
唐文波
高涌
余朝文
聂中林
陈世远
宋涛
卢冉
孙勇
官泽宇
王孝高
徐超
Tang Wenbo;Gao Yong;Yu Chaowen;Nie Zhonglin;Chen Shiyuan;Song Tao;Lu Ran;Sun Yong;Guan Zeyu;Wang Xiaogao;Xu Chao(Department of Vascular Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)
出处
《中华解剖与临床杂志》
2020年第4期401-405,共5页
Chinese Journal of Anatomy and Clinics
基金
蚌埠医学院科技发展基金(BYKF17102)。
关键词
闭塞性动脉硬化
下肢
杂交手术
血管腔内技术
Arteriosclerosis obliterans
Lower extremity
Hybridization surgery
Endovascular technique
