下肢动脉硬化闭塞症介入性综合治疗的临床疗效观察

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1、下肢动脉硬化闭塞症介入性综合治疗的临床疗效观陈中安徐发明(四川省广安市邻水县人民医院影像科638500)【摘要】目的探讨介入性综合治疗在下肢动脉硬化闭塞症(Arteriosclerosisobliterans,ASO)中的临床疗效。材料和方法回顾性分析经数字血管造影(DSA)证实的下肢动脉硬化闭塞症患者21例，共29条肢体；所有病例均行术前下肢CTA或术中DSA检查，先了解血流动力学变化,再分别采用不同的介入治疗方法；总结分析患者介入治疗技术、临床疗效、并发症及随访情况。结果28条肢体均获技术成功，介入综合治疗的成功率为96.6%(28/29),并发症发生率为13.8%(4/

2、29),括穿刺点局限性血肿2例，动脉穿孔2例，无死亡病例。术后，成功进行介入手术者患侧肢体缺血症状完全消失或明显改善，术后DSA造影示狭窄的血管复通，患侧肢体踝肱指数(ABI)明显升高(P<0.05)。术后随访6个月，2例患者发生再狭窄并有明显患侧肢体缺血表现，经PTA解除，一期通畅率为92.9%(26/28),患侧肢体保全率为100%(28/28)。结论介入性综合治疗方法在下肢动脉硬化闭塞症的治疗中安全、有效且并发症少，值得在临床中推广。【关键词】介入综合治疗下肢动脉硬化闭塞症临床疗效【中图分类号】R45【文献标识码】A【文章编号】2095-1752(2013)25-011

3、1-03Theclinicaleffectobservationofinterventionalcomprehensivetherapyinarteriosclerosisobliterans【Abstract】ObjectiveToevaluatetheclinicalvalueofinterventionalcomprehensivetherapyinarteriosclerosisobliterans(ASO).MethodsTheclinicaldataof21cases(29limbs)withASOwereanalyzedretrospectively;allth

4、ecasesreceivedDSAorCTAexaminationtoinvestigatethehemodynamicchangesbeforetheoperation.Differentinterventiontherapieswereperformedbasedontheactualsituation.Interventionaltherapeutictechnique,clinicalefficacy,complicationsanddataoffollow-upwereanalysisedindividually.ResultsAll28limbsweresucce

5、ssfullyplaced;successrateofinterventionalcomprehensivetherapywas96.6%(28/29);thecomplicationrateofinterventionalcomprehensivetherapywas13.8%(4/29),including2casesoflocalizedhematomainpuncturepointand2casesofarteryperforation.Nodeathsoccurred.Thesymptomsweresignificantlyimprovedinthosepatien

6、tswhoweresuccessfullyplacedinterventionalcomprehensivetherapyaftersurgery;DSAcarriedoutimmediatelyaftertheprocedureshowedangiostenosiswereexcluded;ankle-brachialindexofthetroublesidebodyincreasedsignificantly(P<0.05).After6monthsofsurgery,therewere2casesrestenosis,whichwereexcludedwithPTA.T

7、heprimarypatencyratewas92.9%(26/28);Thelimbsalvageratewas100%(28/28).ConclusionInterventionalcomprehensivetherapyforarteriosclerosisobliteransishandy,safe,effectiveandlesssyndrome;whichisworthyofapplicationanddisseminationinclinic.【KeyWords】Interventiona