目的:评价膝下动脉闭塞球囊扩张成形术和动脉旁路术的治疗效果。方法:回顾性分析2005年12月至2009年5月北京协和医院收治的膝下动脉闭塞重症下肢缺血病例,全部资料都是前瞻性收集并录入数据库,并将治疗结果进行回顾性分析。根据膝下动脉初次处理手段的不同分为2组:球囊扩张成形术(PTA)组、以膝下动脉为流出道行自体静脉旁路移植术(bypass surgery,BPS)组,比较2组手术及随访结果。结果:PTA组54例(61条肢体),男性37例,女性17例,平均年龄66岁;手术前后踝肱指数(ABI)由(0.43±0.27)增加至(0.86±0.21),随访期间一期通畅率63.8%,二期通畅率74.1%,救肢率88.3%。动脉旁路术组17例(17条肢体),男性12例,女性5例,平均年龄67岁,ABI由(0.21±0.19)增加至(0.73±0.38),手术通畅率60%,救肢率87.5%。2组治疗结果差异无统计学意义。结论:膝下动脉腔内成形术的临床治疗效果不次于膝下动脉旁路手术,可以作为膝下动脉闭塞首选的治疗方法。 Objective: To evaluate the therapeutic effect of knee artery occlusion balloon angioplasty and arterial bypass surgery. Methods: Retrospective analysis of the cases of severe lower extremity ischemia of lower extremity arteries occluded in Peking Union Medical College Hospital from December 2005 to May 2009, all the data were collected prospectively and entered the database, and the treatment results were retrospectively analyzed. According to the different means of initial treatment of inferior arteries, they were divided into two groups: balloon-operated angioplasty (PTA) group, bypass surgery (BPS) group with inferior carotid artery as outflow tract, and the results of operation and follow-up . Results: There were 54 cases (61 limbs) in PTA group, including 37 males and 17 females, with a mean age of 66 years. The ankle brachial index (ABI) increased from (0.43 ± 0.27) to (0.86 ± 0.21) before and after surgery, Period patency rate of 63.8%, two patency rate of 74.1%, salvage rate of 88.3%. Arterial bypass group, 17 cases (17 limbs), 12 males and 5 females, mean age 67 years. The ABI increased from (0.21 ± 0.19) to (0.73 ± 0.38), operative patency rate was 60% 87.5%. There was no significant difference between the two groups in treatment outcome. Conclusions: The clinical effect of inferior carotid artery endoloplasty is inferior to inferior knee artery bypass surgery, which can be used as the preferred treatment for lower carotid artery occlusion.