超声消融联合球囊扩张和支架置入对下肢动脉长段闭塞的临床研究

目的：通过与单独球囊扩张和支架植入比较，评价超声消融联合球囊扩张和支架植入治疗下肢动脉长段闭塞的疗效及安全性。方法筛选我院2010年1月～2013年9月下肢动脉闭塞症患者，选取满足条件的40例存在长段动脉闭塞患者。随机分为2组，治疗组采用超声消融联合球囊扩张和支架植入治疗，对照组采用单纯球囊扩张和支架植入治疗。观察治疗组与对照组两组术前、术后2周患者跛行距离、足部皮温及ABI变化。结果 A组与B组中共11例患者下肢溃烂，术后经局部换药后2周内全部愈合。 A组成功率为97．0％，而B组成功率为87．1％．A组和B组术后2周与术前相比，足部皮温、ABI及间歇性跛行距离均得到明显改善，具有统计学意义（P＜0．05）。术后2周A组与B组比较，足部皮温、ABI及间歇性跛行距离改善无统计学意义（P＞0．05）。术后造影A组较B组有更丰富的侧枝循环。手术并发症：A组并发症发生率6．1％，B组并发症发生率19．3％．结论血管内超声消融联合球囊扩张成形和支架植入治疗下肢动脉完全闭塞比单纯球囊扩张和支架植入的成功率高、并发症少。血管内超声消融联合球囊扩张成形和支架植入治疗下肢动脉完全闭塞的长期疗效有待进一步观察。

The Clinical Research of Ultrasound Ablation Combined with Balloon Angioplasty and Stents for Long Period of Lower Limb Artery Occlusion

Objective To explore the complications , efficacy and safety of ultrasound ablation combined with balloon angioplasty and stens by comparing with the implantation of balloon angioplasty and stents .Methods Four-ty patients that met the conditions of long artery occlusion were enrolled and divided into two groups randomly .The treat-ment group received ultrasound ablation combined balloon and stent implantation ,and the control group received balloon angioplasty and stent implantation .The claudication distance ,foot skin temperature and ABI of patients in the preopera-tive and postoperative 2 weeks were Observed .Results The ulcers of 11 patients in Group A and Group B were cured after 2 weeks.In the groupA,the success rate was 97.0%.While in the group B,the success rate was 87.1%.Compared with preoperative and postoperative 2 weeks,the foot skin temperature ,ABI and intermittent claudication distance were significantly improved,with statistical significance in the group A and the group B （P〈0.05）.Compared the group A with the group B,the foot skin temperature,ABI and intermittent claudication distance were not statistically significant improvement in postoperative 2 weeks（P〉0.05）.The group A had richer circulation than the group B .The complication rate of group A was 6 .1%, and the group B was 19 .3%.Conclusions 1 Intravascular ultrasound ablation combined balloon and stent implantation has a higher success rate and fewer complications than that of balloon and stent implanta -tion for long period of lower limb artery occlusion .2 The long-term efficacy of intravascular ultrasound ablation combined balloon and stent implantation for lower artery occlusion remains to be seen .