巧克力球囊扩张血管成形术治疗糖尿病膝下动脉闭塞病变的疗效

doi:10.3969/j.issn.1004-583X.2021.04.009

摘要/Abstract

摘要：

目的探讨应用巧克力球囊扩张血管成形术治疗糖尿病膝下动脉闭塞病变的疗效和安全性。方法选择2020年9月至2021年2月糖尿病膝下动脉闭塞病变患者56例,随机分为2组,每组28例。对照组患者应用普通球囊实施经皮膝下动脉腔内血管成形术介入治疗,观察组患者应用巧克力球囊进行介入治疗。观察两组手术成功率及术中限流性夹层形成情况,比较两组患者手术前后踝肱压指数(ABI)、经皮氧分压变化(tcpO₂)及症状改善情况等。结果观察组和对照组技术成功率均为100%,手术成功率分别为96.43%和89.29%。观察组术中6条(6/39)膝下动脉球囊扩张后形成限流性夹层,对照组15条(15/40),限流性夹层发生率明显低于对照组(P<0.05);观察组ABI、tcpO₂改善明显优于对照组(P<0.05);两组术后症状均有明显改善。结论应用巧克力球囊扩张成形术治疗膝下动脉闭塞病变疗效较好,可有效降低限流性夹层发生,近期疗效更具优势。

关键词: 糖尿病, 巧克力球囊, 血管成形术, 膝下动脉闭塞, 疗效

Abstract:

Objective To investigate the efficacy and safety of chocolate balloon dilatation angioplasty on diabetic patients with infrapopliteal artery occlusion. Methods Fifty-six diabetic patients with infrapopliteal artery occlusion from September 2020 to February 2021 were selected and randomly divided into two groups with 28 patients in each group. The control group was treated with ordinary balloon for interventional treatment of percutaneous infrapopliteal artery intraluminal angioplasty, while the observation group was treated with chocolate balloon. The operative success rate, intraoperative flow limiting dissection formation were observed between the two groups; the ankle-brachial index(ABI), transcutaneous oxygen pressure(tcpO₂), and symptom improvement were compared between the two groups before and after surgery. Results The success rate of technology in the observation group and the control group were both 100%, and the success rate of operation were 96.43% and 89.29%, respectively; 6 infrapopliteal arteries formed flow restriction dissections after balloon dilation in the observation group (6/39) , and 15 infrapopliteal arteries formed in the control group (15/40).The rate of intraoperative flow limiting dissection formation in the observation group was lower than that in the control group(P<0.05). ABI and tcpO₂ in the observation group were significantly better than that in the control group(P<0.05). Symptoms were significantly improved after surgery in the both groups. Conclusion The application of chocolate balloon dilatation in the treatment of infrapopliteal artery occlusion is satisfactory, can effectively reduce the occurrence of flow limiting dissection, the short-term effect is more superior.

Key words: diabetes, chocolate balloon, angioplasty, infrapopliteal artery occlusion, curative effect

中图分类号:

R587.1

王文琦, 马红芳, 杜亚萍, 丁海霞, 白磊, 王富军. 巧克力球囊扩张血管成形术治疗糖尿病膝下动脉闭塞病变的疗效[J]. 临床荟萃, 2021, 36(4): 336-339.

Wang Wenqi, Ma Hongfang, Du Yaping, Ding Haixia, Bai Lei, Wang Fujun. Therapeutic effect of chocolate balloon dilatation angioplasty on diabetic infrapopliteal artery occlusion[J]. Clinical Focus, 2021, 36(4): 336-339.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.04.009

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I4/336

图/表 2

参考文献 15

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组别		1支动脉闭塞			2支动脉闭塞			3支动脉闭塞			合计
组别		胫前	胫后	腓	胫前	胫后	腓	胫前	胫后	腓	合计
观察组	闭塞动脉	2	2	0	17	16	3	6	6	6	58
	开通动脉	2	2	0	11	13	2	3	4	2	39
	夹层形成	0	0	0	2	2	0	1	1	0	6
对照组	闭塞动脉	2	1	0	17	18	3	6	6	6	59
	开通动脉	2	1	0	11	14	2	2	5	3	40
	夹层形成	0	0	3	4	5	1	1	1	0	15

组别		1支动脉闭塞			2支动脉闭塞			3支动脉闭塞			合计
组别		胫前	胫后	腓	胫前	胫后	腓	胫前	胫后	腓	合计
观察组	闭塞动脉	2	2	0	17	16	3	6	6	6	58
	开通动脉	2	2	0	11	13	2	3	4	2	39
	夹层形成	0	0	0	2	2	0	1	1	0	6
对照组	闭塞动脉	2	1	0	17	18	3	6	6	6	59
	开通动脉	2	1	0	11	14	2	2	5	3	40
	夹层形成	0	0	3	4	5	1	1	1	0	15

组别	例数	ABI		tcpO₂(mmHg)
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	28	0.460±0.102	0.861±0.174^*	37.71±9.47	51.82±6.91^*
对照组	28	0.459±0.089	0.750±0.149^*	38.07±8.38	46.36±7.40^*
t值		0.042	2.571	0.149	2.856
P值		0.967	0.013	0.882	0.006

组别	例数	ABI		tcpO₂(mmHg)
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	28	0.460±0.102	0.861±0.174^*	37.71±9.47	51.82±6.91^*
对照组	28	0.459±0.089	0.750±0.149^*	38.07±8.38	46.36±7.40^*
t值		0.042	2.571	0.149	2.856
P值		0.967	0.013	0.882	0.006