下肢动脉硬化闭塞症腔内治疗中逆穿技术的应用效果及影响因素分析
Study on the effect and influencing factors of the retrograde approach technique in the endovascular therapy of athero-sclerosis obliterans
张智涛 1李延俊 1孙岩2
作者信息
- 1. 山东省滨州市第二人民医院医学影像科 山东 滨州 256800
- 2. 山东第一医科大学附属省立医院血管外科 山东 济南 250021
- 折叠
摘要
目的 探讨下肢动脉硬化闭塞症腔内治疗中逆穿技术的应用效果及其影响因素.方法 选取实施腔内治疗的 70 例下肢动脉硬化闭塞症患者,实施逆穿技术的 35 例患者为逆穿组,未实施逆穿技术的 35 例患者为对照组,统计逆穿组患者手术前后患肢踝肱压力指数、患侧足部温度、间歇性跛行距离和术后并发症发生率,对比两组患者性别、年龄等资料,筛选影响逆穿技术实施的因素,绘制受试者工作特征曲线并计算曲线下面积评价影响因素的预测效能.结果 逆穿组患者术后踝肱压力指数、患侧足部温度和间歇性跛行距离较术前明显提高,差异有统计学意义(P<0.05);闭塞管腔近心端斑块面积和斑块负荷是影响逆穿技术实施的影响因素.结论 逆穿技术是下肢动脉硬化闭塞症腔内治疗中的重要手段,可有效改善下肢血液供应;医师术前可通过测量闭塞管腔近心端斑块面积和斑块负荷预估术中逆穿技术的实施概率并制定手术方案.
Abstract
Objective To investigate the effect and influencing factors of retrograde approach technique in the atherosclero-sis obliterans(ASO)endovascular therapy.Methods 70 ASO patients who underwent endovascular therapy were enrolled in this study.35 patients who underwent the retrograde approach technique were separated into the retrograde group,and the 35 pa-tients who did not undergo the retrograde technique were separated into the control group.The ankle-brachial index(ABI)of the affected limb,the temperature of the affected foot,the distance of intermittent claudication before and after surgery,and postop-erative complications were analyzed in the retrograde group.The clinical data,such as gender,age,of the two groups were com-pared to screen the influencing factors of the retrograde approach during endovascular therapy.The predictive accuracy of the in-fluencing factors was verified by plotting the receiver operating characteristics curve.Results The postoperative ABI,the af-fected foot temperature,and intermittent claudication distance of patients in the retrograde group were significantly higher than those before surgery,the difference was statistically significant(P<0.05).Plaque area and plaque burden in the proximal part of the occluded lumen were the influencing factors of the implementation of the retrograde technique.Conclusion Retrograde ap-proach is an important method in the ASO endovascular therapy,which can effectively improve the blood supply to the lower ex-tremity.Medical practitioners can predict the probability of implementation of the retrograde approach by measuring the plaque area and plaque burden in the proximal part of the occluded lumen before surgery.
关键词
下肢动脉硬化闭塞症/腔内治疗/逆穿技术/介入性,放射学Key words
Atherosclerosis obliterans/Endovascular therapy/Retrograde approach technique/Interventional,Radiology引用本文复制引用
基金项目
山东省中医药科技发展计划(2019-0303)
山东省医药卫生科技发展计划(2018WS273)
出版年
2024
NETL
NSTL
维普
万方数据