PTA＋Stent对股－腘动脉硬化闭塞症临床症状及结局的影响.docVIP

精品论文 参考文献 PTA＋Stent对股－腘动脉硬化闭塞症临床症状及结局的影响 王　亮 　　成都市第一人民医院普外科　四川　成都　６１００００ 　　【摘要】　目的　分析PTA＋Stent对股－腘动脉硬化闭塞症临床症状、体征改善状况及近远期疗效.方法　将９７例股－腘动脉硬化闭塞症(TASCC型) 患者随机分旁路组和介入组,观察两组临床症状改善程度及住院时间.结果　两组术后半月ABI状况显著升高(P＜０．０１),术后半年、术后１年、术后２年开始下降(P＜０．０１),两组间在术后半月、术后半年、术后１年、术后２年存在显著差异(P＜０．０１);两组术后半月Doppler通畅率状况显著升高(P＜０．０１),术后半年、术后１年、术后２年开始下降(P＜０．０１),两组间在术后１年、术后２年Doppler通畅率状况存在显著差异(P＜０．０５).结论　两种手术方式近期疗效相同,PTA＋Stent恢复时间快、并发症少,人工血管旁路术中远期通畅率高,应根据患者病情选择具体术式. 【关键词】　血管腔内介入术;人工血管旁路术;股－腘动脉硬化闭塞症;踝肱指数【Abstract】Objective　ToanalyzethePTA＋Stentoffemoralpoplitealarteryocclusivedisease,clinicalsymptomsandsignstoimprovethesituationinthelong－termcurativeeffect．Methods　９７patientswithfemoralpoplitealarterioscleroticocclusion(TASCCtype)patientswererandomlydividedintobypassgroupandinterventiongroup,observetwogroupsofclinicalsymptomsimprovementandhospitalizationtime．Results　theABIstatusofthetwogroupswassignificantlyhigher(P＜０．０１),thefirsthalfofthe１yearsaftersurgery,yearsaftertheoperationand２yearsaftertheoperation(P＜０．０１),Thereweresignificantdifferencesbetweenthetwogroupsinthe１year,yearsafteroperationand２yearsafteroperation(P＜０．０１);Inthetwogroups,thepatencyrateofDopplerwassignificantlyhigher(P＜０．０１),andthefirsthalfofthe１year,yearsafteroperationand２yearafteroperation(P＜０．０１),Betweenthetwogroupsafter１years,after２yearsofDopplerpatencyratehassignificantdifference(P＜０．０５)．Conclusion　thetwosurgicalmethodswerethesameinthenearfuture,therecoverytimeofPTA＋Stent【Kweaysfwaosrtdasn】dthecomplicationswerefew．Thelong－termpatencyrateofartificialbloodvesselbypasswashigh． endovascularintervention;artificialvascularbypass;femoralpoplitealarteryocclusivedisease;anklebrachialindex 【中图分类号】R４７３．６ 【文献标识码】B 　　【文章编号】１００８－６３１５(２０１５)１２－０９０３－０２　　 　　近年来,血管腔内介入术与人工血管旁路术作常见手术方式被广泛应用[１－２],但术后存在移植物或支架内血栓形成引起再狭窄或闭塞等缺点不能完全避免,远期通常率需要进一步研究[３].本次报告如下: １　资料与方法１．１　资料:病例来自２０１３年１月到２０１５年２月我院股－腘动脉硬化闭塞症(TASCC型)患者９６例,旁路组５１例,采用人工血管旁路术;介入组４６例,采用血管腔内介入术,两组间基本状况无差异(P＞０．０５). １．２　手术方法　旁路组采用人工血管旁路术,脊膜外麻醉或全麻满意后,使用隧道器将隧道分离好,根据患者情况采用合适人工血管与近端的股动脉行端侧和远端的腘动脉行端侧吻合.确认成功后