【摘要】 目的 观察膝下动脉血运重建联合足底-足背弓腔内成形术(PPL)治疗慢性肢体威胁性缺血(CLTI)合并2型足动脉弓的效果。方法 回顾性分析238例接受膝下动脉血运重建的CLTI合并2型足动脉弓患者，140例术中同时行PPL(PPL组)、98例未行PPL(非PPL组)。于治疗后1、3、6及12个月进行随访，比较2组累积创面愈合率及保肢率。结果 随访期间PPL组2例截肢、8例死亡(包括1例截肢者),治疗后12个月保肢率93.57%(131/140);非PPL组11例截肢、8例死亡(包括3例截肢者),治疗后12个月保肢率83.67%(82/98);组间保肢率差异有统计学意义(χ~2=6.008,P=0.014)。PPL组治疗后1、3、6及12个月累积创面愈合率分别为12.86%(18/140)、47.14%(66/140)、70.00%(98/140)及85.71%(120/140),非PPL组分别为7.14%(7/98)、37.76%(37/98)、51.02%(50/98)及78.57%(77/98);PPL组治疗后6个月累积创面愈合率高于非PPL组(P<0.05),治疗后1、3及12个月组间差异均无统计学意义(P均>0.05)。结论 膝下动脉血运重建联合PPL治疗CLTI合并2型足动脉弓效果较好，可在一定程度上提高创面愈合率和保肢率。更多还原

【Abstract】 Objective To observe the effect of infrapopliteal arterial revascularization combined with pedal and plantar loop angioplasty(PPL) for treating chronic limb-threatening ischemia(CLTI) complicated with type 2 pedal arch. Methods Data of 238 CLTI complicated with type 2 pedal arch patients who underwent successfully infrapopliteal arterial revascularization were retrospectively analyzed, including 140 cases underwent simultaneously PPL(PPL group) but 98 cases did not(non-PPL group) during operation. The rate of cumulative wound healing and limb salvage at 1, 3, 6 and 12 months after operation were compared between groups. Results During follow-up, amputations occurred in 2 cases and 8 cases died(including 1 case of amputation) in PPL group, and the rate of limb salvage was 93.57%(131/140) at 12 months after operation. In non-PPL group, amputations occurred in 11 cases and 8 cases died(including 3 cases of amputation), with the rate of limb salvage of 83.67%(82/98) at 12 months after operation. The limb salvage rates at 12 months after operation were significantly different between groups(χ~2=6.008, P=0.014). The cumulative wound healing rate of PPL group was 12.86%(18/140), 47.14%(66/140), 70.00%(98/140) and 85.71%(120/140) at 1, 3, 6 and 12 months after operation, respectively, while of non-PPL groups was 7.14%(7/98), 37.76%(37/98), 51.02%(50/98) and 78.57%(77/98), respectively. The cumulative wound healing rate of PPL group was higher than that of non-PPL group at 6 months after operation(P<0.05), but not at 1, 3 and 12 months after operation(all P>0.05). Conclusion Infrapopliteal arterial revascularization combined with PPL was valuable for treating CLTI complicated with type 2 pedal arch, which could improve wound healing rate and limb salvage rate to a certain extent.更多还原