不同类型球囊扩张对下肢动脉硬化闭塞症患者疗效及安全性的影响

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目的:探讨普通球囊(POBA)和药物涂层球囊(DCB)对下肢动脉硬化闭塞症患者疗效及安全性的影响。方法:选取山西省运城市中心医院2016年2月至2018年2月收治下肢动脉硬化闭塞症患者共70例,以随机抽签法分为对照组(35例)和观察组(35例),均行腔内介入手术,其中观察组采用POBA和DCB治疗,对照组则采用DCB治疗,比较两组靶血管一期通畅率、靶病变血运重建率、手术前后最小管腔直径和踝肱指数(ABI)水平、术后随访Rutherford分级、术后随访晚期管腔丢失量及围手术期并发症发生率。结果:观察组术后6个月和12个月靶血管一期通畅率均显著高于对照组[(85.71%(30/35)比62.86%(22/35)、80.00%(28/35)比48.57%(17/35)],n P<0.05;观察组靶病变血运重建率显著低于对照组[8.57%(3/35)比28.57%(10/35)],n P<0.05;观察组术后6个月和12个月最小管腔直径均显著大于对照组、术前[(3.20 ± 0.66) mm比(1.53 ± 0.38)和(0.45 ± 0.09) mm、(2.97 ± 0.60) mm比(1.40 ± 0.35)和(0.45 ± 0.09) mm],差异有统计学意义(n P<0.05);观察组术后6个月和12个月ABI水平均显著高于对照组、术前(0.86 ± 0.17比0.63 ± 0.09和0.24 ± 0.06、0.82 ± 0.14比0.60 ± 0.08和0.24 ± 0.06),n P3级比例均显著低于对照组[(0.42 ± 0.10) mm比(1.59 ± 0.32) mm、17.14%(6/35)比57.14%(20/35)];同时观察组围手术期并发症发生率显著低于对照组(n P<0.05)。n 结论:DCB用于下肢动脉硬化闭塞症患者疗效及安全性均优于POBA,更具有临床应用价值。“,”Objective:To investigate the influence of plain old balloon angioplasty (POBA) and drug-coated balloon (DCB) dilatation on clinical efficacy and safety in patients with lower extremity arteriosclerosis obliterans.Methods:Seventy patients with lower extremity arteriosclerosis obliterans from February 2016 to February 2018 in Central Hospital of Yuncheng City, Shanxi Province were chosen. The patients were divided into control group (35 patients) with POBA dilatation and observation group (35 patients) with POBA and DCB dilatation by random sampling method. The target vessel patency rate, target lesion revascularization rate, minimum lumen diameter and ankle brachial index (ABI) level before and after surgery, Rutherford classification in follow-up after surgery, late lumen loss after surgery and perioperative complications incidence of 2 groups were compared.Results:The target vessel patency rate 6 and 12 months after surgery in observation group was significantly higher than that in control group: 85.71% (30/35) vs. 62.86% (22/35) and 80.00% (28/35) vs. 48.57% (17/35), and there was statistical difference (n P<0.05). The target lesion revascularization rate in observation group was significantly lower than that in control group: 8.57% (3/35) vs. 28.57% (10/35), and there was statistical difference (n P<0.05). The minimum lumen diameter 6 and 12 months after surgery in observation group was significantly more than that in control group and before surgery: (3.20 ± 0.66) mm vs. (1.53 ± 0.38) and (0.45 ± 0.09) mm, (2.97 ± 0.60) mm vs. (1.40 ± 0.35) and (0.45 ± 0.09) mm, and there was statistical difference (n P<0.05). The ABI 6 and 12 months after surgery in observation group was significantly higher than that in control group and before surgery: 0.86 ± 0.17 vs. 0.63 ± 0.09 and 0.24 ± 0.06, 0.82 ± 0.14 vs. 0.60 ± 0.08 and 0.24 ± 0.06, and there was statistical difference (n P3 12 months after surgery in observation group were significantly less than those in control group: (0.42 ± 0.10) mm vs. (1.59 ± 0.32) mm and 17.14% (6/35) vs. 57.14%(20/35), and there were statistical differences (n P<0.05). The perioperative complications incidence in observation group was significantly lower than that in control group (n P<0.05).n Conclusions:Compared with POBA dilatation, DCB dilatation in the treatment of patients with lower extremity arteriosclerosis obliterans possesses better clinical efficacy and safety.
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