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目的评价下肢动脉缺血性疾病的血管造影诊断价值及介入治疗效果。方法对75例下肢动脉缺血性疾病患者行下肢动脉血管造影检查,并对检查结果进行评估,测量狭窄段血管的长度及狭窄率,将其中同意行介入治疗的30例患者(39条患肢)纳入介入治疗组,治疗使用球囊导管进行扩张,对下肢动脉严重狭窄者行自膨式支架置入术。将拒绝行介入治疗的45例患者(60条患肢)纳入保守治疗组,采用内科保守药物治疗。临床随访6～36个月,观察术中血管再通及治疗后患者下肢缺血症状改善情况。对介入治疗组和保守治疗组临床疗效进行比较。结果介入治疗组技术成功率为100%,临床有效率为90.0%,1年内发生再狭窄而导致截肢率为10.0%;保守治疗组临床有效率为62.2%,截肢率为37.8%,两组间差异有统计学意义(P<0.05)。介入治疗组3年开通率为57.7%,截肢率为23.1%。结论介入治疗下肢动脉缺血性疾病可明显改善患者临床症状,提高临床有效率,是治疗下肢动脉缺血性疾病的有效方法。
Objective To evaluate the diagnostic value of angiography and interventional treatment of lower extremity arterial ischemic disease. Methods 75 patients with lower extremity arterial ischemic disease underwent lower extremity arterial angiography, and to assess the results of the test to measure the length of the stenosis segment and stenosis rate, which agreed to intervene in 30 patients (39 limbs ) Were included in the interventional treatment group, the treatment of balloon catheter expansion, severe stenosis of the lower extremity line self-expanding stent placement. Forty-five patients (60 limbs) who refused to intervene were included in the conservative treatment group and were treated with conservative medical treatment. Clinical follow-up 6 to 36 months, observed intraoperative revascularization and treatment of patients with lower limb ischemia improved. The interventional treatment group and conservative treatment group clinical efficacy comparison. Results The technical success rate was 100% in the intervention group, the clinical effective rate was 90.0%, the restenosis rate was 10.0% in one year and the effective rate in the conservative treatment group was 62.2% and the amputation rate was 37.8% The difference was statistically significant (P <0.05). Interventional treatment group 3-year opening rate was 57.7%, amputation rate was 23.1%. Conclusion Interventional treatment of lower extremity arterial ischemic disease can significantly improve clinical symptoms and improve clinical efficiency, which is an effective method for the treatment of ischemic diseases of the lower extremities.