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目的探讨经桡、股动脉序贯途径腔内治疗下肢动脉硬化闭塞症的可行性与疗效;与经股动脉、桡动脉途径比较,探讨最佳腔内治疗入路。方法回顾性分析我院2003年1月以来采用经不同途径腔内治疗的46例下肢动脉硬化闭塞的患者的临床资料。结果经股动脉途径治疗15例,平均溶栓时间为3天,3例穿刺口出血而终止治疗、4例由于无法忍受长时间制动而自动放弃治疗;行球囊扩张和或支架成形术有8例,6例术后患肢血流恢复。经桡动脉途径治疗有21例,溶栓时间平均长达10天,溶栓时间均较经股动脉途径要长;术后踝肱指数升高较经股动脉途径明显,但下肢血流恢复与经股动脉途径无显著差异。经桡、股动脉序贯途径治疗10例,术后平均踝肱指数大于1,下肢血流的恢复率达90%,均较其他两组显著提高。结论经经桡、股动脉序贯途径是腔内治疗下肢动脉硬化闭塞症最佳选择,下肢血流的恢复率高。
Objective To investigate the feasibility and efficacy of sequential treatment of radial and femoral arterial endovascular treatment of arteriosclerosis obliterans in lower extremities. To explore the optimal endovascular approach compared with the approach of trans-arterial and radial artery via femoral artery and radial artery. Methods The clinical data of 46 patients with lower extremity arterial occlusive disease treated by endovascular therapy in different ways in our hospital from January 2003 were retrospectively analyzed. Results The treatment of 15 cases by the femoral artery approach, the average thrombolytic time was 3 days, 3 cases of bleeding to terminate the treatment of puncture, 4 cases because of unbearable long-term braking and give up treatment; balloon dilatation and or stent 8 cases, 6 cases of postoperative limb blood flow recovery. Transradial approach to treatment of 21 cases, an average of thrombolytic therapy up to 10 days, thrombolysis time than by the femoral artery approach longer; postoperative ankle-brachial index than the femoral artery pathway, but lower limb blood flow recovery and There was no significant difference in the femoral artery approach. Transradial and femoral artery sequential treatment of 10 cases, the average postoperative ankle-brachial index greater than 1, lower limb blood flow recovery rate of 90%, were significantly higher than the other two groups. Conclusion The sequential approach of transradial and femoral arterial approach is the best choice for endovascular treatment of arteriosclerosis obliterans in lower extremities, and the recovery rate of lower extremity blood flow is high.