微球囊血管腔内成形术治疗膝下动脉闭塞性疾病
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赵堂海

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Percutaneous transluminal angioplasty with microballoon in the treatment of infrapopliteal artery occlusive disease
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    摘要:

    目的:观察微球囊血管腔内成形术治疗膝下动脉闭塞性疾病的疗效。
    方法:对采用微球囊血管腔内成形术治疗的32例(37条肢体)膝下动脉闭塞性疾病患者的临床资料进行回顾性分析。按Fontaine分期:Ⅲ期22条患肢(59.5%),Ⅳ期15条患肢(40.5%)。术前踝/肱指数(ABI)为0.22±0.20。
    结果:技术成功35条肢体,成功率94.6%。35条肢体中术后静息痛消失21条肢体(60.0%),明显缓解12条肢体(34.3%),减轻2条肢体(5.7%);8例足部溃疡患者中愈合3条肢体,缩小5例。膝下截肢1条肢体,半足切除2条肢体。术后ABI 0.73±0.21,较术前有显著提高(P<0.01)。手术成功的35条肢体均行术后随访,随访时间1~29个月,平均13.6个月。随访中2条肢体分别于术后6,14个月再次出现静息痛,经二次经皮血管腔内成形术(PTA)治疗后症状消失;其余33条肢体症状、体征均无加重或复发。
    结论:微球囊血管腔内成形术治疗膝下动脉闭塞性疾病安全可行,且创伤小、恢复快、近期疗效确切。远期效果有待进一步观察。

    Abstract:

    Abstract:Objective:To evaluate the effect of percutaneous transluminal angioplasty(PTA) with microballoon for patients with infrapopliteal artery occlusive disease.
    Methods :The clinical materials of 32 cases(37 limbs) with infrapopliteal artery occlusive disease treated by PTA with microballoon were retrospectively studied.According to Fontaine staging, 22 limbs(59.5%) were in stage Ⅲ and 15 limbs(40.5%) in stage Ⅳ.Preoperative ABI was 0.22±0.20.
    Results:The technical success rate was of 94.6% (35 limbs).Of these limbs,rest pain disappeared in 21 limbs(66.0%) and clinical symptoms were relieved obviously in 12 limbs(34.3%).Of the preoperative foot ulcers in 9 limbs,3 healed.Of the 6 limbs with foot or toe gangrene,1 underwent below-knee amputation and 2 received partial foot amputation.The postoperative ABI was 0.73±0.21.All the 35 limbs with successful operation were followed up with an average period of 13.6 (1~29) months. During follow-up, 2 limbs had recurrence of rest pain at 6m and 14m after operation, respectively; and the symptoms were relieved after a second PTA. The signs and symtpoms in the other 33 limbs did not increase or recur.
    Conclusions:PTA with microballoon is a feasible technique in the treatment of infrapopliteal artery occlusive disease,especially in poor risk patients.Long-term results need to be further studied.

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赵堂海, 于永山, 张杰, 王海波, 谢远峰, 曲丽媛.微球囊血管腔内成形术治疗膝下动脉闭塞性疾病[J].中国普通外科杂志,2008,17(6):4-538.
DOI:10.7659/j. issn.1005-6947.2008.06.004

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  • 在线发布日期: 2008-06-25