上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

分期腔内开通技术治疗严重肢体缺血的初步探讨

刘光，李维敏，陆信武，黄新天，陆民，蒋米尔   

  1. 上海交通大学 医学院附属第九人民医院血管外科  血管病诊治中心， 上海 200011
  • 出版日期:2016-02-28 发布日期:2016-03-29
  • 通讯作者: 蒋米尔, 电子信箱: jiangme2013@163.com。
  • 作者简介:刘光（1982—)， 男， 主治医师， 博士; 电子信箱: liuguang1982@163.com。

Preliminary investigation of treating patients with critical limb ischemia by staged endovascular technology

LIU Guang, LI Wei-min, LU Xin-wu, HUANG Xin-tian, LU Min, JIANG Mi-er   

  1. Department of Vascular Surgery, Vascular Center, Shanghai Ninth Peoples Hospital， Shanghai Jiao Tong University School of Medicine, Shanghai 200011， China
  • Online:2016-02-28 Published:2016-03-29

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摘要：

目的 探讨分期腔内开通技术在严重下肢肢体缺血高危患者中的应用效果。方法 2013年9月—2015年3月共计16例严重下肢病变患者(均为髂动脉及远端动脉闭塞，TASC-ⅡD)接受分期腔内动脉成形术，收集患者的临床资料并进行回顾性分析，平均随访时间为7.8个月。结果 所有病例技术操作成功。患者静息痛在第一次腔内治疗后消失，无截肢发生，无严重并发症出现。两次治疗过程中，术前、术后踝肱指数（ABI）的差异具有统计学意义（P=0.000）。结论 分期开通技术可以有效缓解高危严重肢体缺血患者的静息痛症状及组织坏死，避免了一次开通所引起的缺血再灌注损伤、急性心血管事件等严重并发症的发生，提高了患者的生存质量。

关键词: 严重下肢缺血, 分期腔内治疗, 动脉成形

Abstract:

Objective To investigate the application of staged endovascular treatment to high-risk patients with critical limb ischemia (CLI). Methods From September 2013 to March 2015, a total of 16 patients with CLI (both iliac artery and distal arterial occlusion, TASC-ⅡD) underwent the staged endovascular angioplasty. Clinical data of patients were collected and retrospectively analyzed. The average follow-up period was 7.8 months. Results The technical success was achieved for all patients. The rest pain of patients disappeared after the first endovascular treatment with no amputation and serious complications. During two treatments, the difference of the ankle brachial index (ABI) before and after surgery was statistically significant (P=0.000). Conclusion The staged endovascular technology can effectively alleviate the symptoms of rest pain and tissue necrosis of high-risk patients with CLI, avoid serious complications such as the ischemia reperfusion injury and acute cardiovascular events caused by unstaged endovascular treatment, and improve the life quality of patients.

Key words: critical limb ischemia, staged endovascular treatment, angioplasty