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目的探讨下肢动脉硬化闭塞性疾病介入治疗方法的选择和临床疗效观测。方法本组53例73处病变(狭窄性48处,闭塞性25处),采用球囊成形、支架成形、腔内旋切和内膜下血管成形等多种介入手段干预、治疗。结果73处病变:单纯球囊成形10例,辅助支架成形20例,均成功;单纯腔内旋切8例,辅助支架成形的14例(19处自膨式支架,1处弹簧式支架),手术失败1例;单纯内膜下血管成形5例,辅助支架成形的11例,手术失败4例。41例临床症状明显改善,20例症状部分缓解,5例疗效欠佳。4例患者因术后缺血再灌注损伤行切开解压后好转,2例因小腿骨筋膜室综合征行膝关节以下离断术。术后平均随访10.5(2~33)个月,2例术后6个月症状复发未予以进一步治疗,1例术后1年再次介入治疗,余患者疗效稳定。结论下肢动脉硬化闭塞症介入治疗方法多样,针对不同类型的病变采用相应的介入治疗手段,临床疗效安全、可靠。
Objective To investigate the choice of interventional therapy for lower extremity arterial occlusive disease and its clinical efficacy. Methods The group of 53 patients with 73 lesions (stenosis of 48, occlusion of 25), using balloon forming, stent forming, endovascular and subintimal angioplasty and other intervention interventions. RESULTS: Of the 73 lesions, 10 were formed by balloon angioplasty alone and 20 were assisted by scaffolds. All of them were successful. Among them, 8 were simply endo-revolving and 14 were scaffolds (19 self-expanding stents and 1 spring-loaded stents) One case failed surgery, 5 cases underwent simple subintimal angioplasty, 11 cases underwent scaffold stenting and 4 cases failed surgery. 41 cases of clinical symptoms improved significantly, 20 cases of partial remission, 5 cases of poor efficacy. Four patients were cured by incision and decompression after ischemia-reperfusion injury, and 2 patients underwent knee-joint ablation due to calf compartment syndrome. After an average follow-up of 10.5 months (2 ~ 33) months, 2 patients were not treated for further symptoms at 6 months after operation. One patient was re-treated one year after operation, and the remaining patients were stable. Conclusion There are many interventional methods for the treatment of arteriosclerosis obliterans in lower extremities. Corresponding interventional methods are used to treat different types of lesions. The clinical efficacy is safe and reliable.