| 陈波 马军 王海涛 孙占峰 姜维良△.介入技术在下肢动脉硬化闭塞症合并血栓形成中的应用[J].,2016,16(2):275-277 |
| 介入技术在下肢动脉硬化闭塞症合并血栓形成中的应用 |
| Application of Interventional Technique in the Treatment of Patients withLower Extremity Arteriosclerosis Obliterans with Thrombosis |
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| DOI： |
| 中文关键词: 导管接触性溶栓 下肢动脉硬化闭塞症 血栓形成 支架成形 |
| 英文关键词: Catheter-directed thrombolysis Lower extremity arteriosclerosis obliterans Thrombosis Stent angioplasty |
| 基金项目:黑龙江省青年科学基金项目（QC2013C115） |
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| 中文摘要: |
| 目的：探讨导管接触性溶栓(catheter-directed thrombolysis，CDT)联合球囊及支架成形术治疗下肢动脉硬化闭塞症合并血栓形
成的临床疗效及安全性。方法：选择2011 年1月～2014 年12 月收治的36 例下肢动脉硬化闭塞症合并血栓形成性病变患者，先
行置管溶栓治疗，再联合球囊及支架成形术治疗，观察其溶栓效果及血管再通情况。结果：本组溶栓总有效率为86.1 %，尿激酶用
量(75.5± 34.6) 万单位，溶栓后31 例下肢缺血症状改善，下肢疼痛症状有不同程度减轻，下肢跛行距离明显延长，无垃圾脚发生。
球囊及支架成形术后踝肱指数(ABI)由术前的0.39± 0.11 升高至术后的0.79± 0.19，差异有统计学意义(P＜0.01)。随访1～48月，
无死亡病例，9 例出现支架内膜增生血管再狭窄，5 例出现糖尿病膝下动脉狭窄闭塞，给予球囊扩张及支架成形术后下肢缺血症
状减轻，其中1 例患者于术后3 年行下肢截肢治疗。结论：CDT 联合球囊及支架成形术治疗下肢动脉硬化闭塞症合并血栓形成具
有较高的临床价值，可以为PTA 血管成形或支架置入赢得时机，改善下肢缺血，该方式创伤小，并发症少。 |
| 英文摘要: |
| Objective:To discuss the clinical efficacy and security of catheter-directed thrombolysis(CDT) combined with balloon
and stent angioplasty in the treatment of patients with lower extremity arteriosclerosis obliterans with thrombosis.Methods:Thirty-six
patients with lower extremity arteriosclerosis obliterans with thrombosis admitted in our hospital from January 2011 to December 2014
were firstly underwent CDT, then balloon and stent angioplasty was performed. The efficacy of thombolysis and recanalization rate were
retrospectively analyzed.Results:The total efficacy rate of thrombolysis was 86.1 %. The urokinase dose was (75.5± 34.6) million units.
After CDT, thirty-one patients with ischemia symptoms showed significant improvements, claudication distance obviously prolonged and
rest pain certainly relieved without garbage feet occurrence. After combined treatment of balloon and stent angioplasty, the ankle/brachial
index (ABI) rose significantly between pre- and post-procedure (0.39 ± 0.11 vs. 0.79 ± 0.19, P＜0.01). No death occurred with a
lollow-up time of 1～48 months. There were 9 patients with vessel restenosis because of intima hyperplasia in stent and 5 patients with
diabetes-associated inferior genicular artery occlusion. After balloon and stent angioplasty, they showed significant improvement in
ischemia symptons. Three years later, one patient underwent amputation after the operation.Conclusion:For lower extremity
arteriosclerosis obliterans with thrombosis, CDT combined with balloon and stent angioplasty had high clinical value. It could gain the
opportunity of PTA or stent insertion and improve the lower limb ischemia with little trauma and less complication. |
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