【作者】 王磊；

【导师】 戈小虎；

【作者基本信息】 石河子大学 ， 外科学， 2015， 硕士

【摘要】 目的:探讨影响下肢动脉硬化闭塞症腔内支架成形术术后下肢缺血症状复发的相关因素。方法:回顾性分析2008年4月-2014年4月乌鲁木齐新疆维吾尔自治区人民医院收治的69例(共70条患肢)下肢动脉硬化闭塞症行腔内支架成形术患者的临床资料,术后给予患者抗血小板聚集及降脂药物、控制血压及血糖等治疗,随访观察治疗结果,采用寿命表法计算患者血管通畅率,用long-rank检验进行缺血症状复发单因素分析,应用COX模型进行缺血症状复发的多因素分析。结果:行PTA支架植入术后68例(69条患肢)患者获得随访,随访时间6~72个月。半年、1、3、5年通畅率分别为90%、71%、39%、31%。2例在术后3月内行踝以上截肢术,术后切口愈合好,保肢率达97.1%。随访过程中死亡6例:2例死于肺部感染,2例死于急性心肌梗死。1例死于糖尿病酮症酸中毒,1例死于高血压脑出血。术后22例症状复发,合并糖尿病、高血压患者均按时服用降糖降压药物,血糖血压均控制在正常范围。单因素分析表明:术前的缺血程度、术后停用抗血小板聚集及降脂药物、功能锻炼对症状复发有影响(P<0.05)。多因素分析显示:术后停用抗血小板聚集及降脂药物是影响术后缺血症状复发的独立危险因素(P<0.05)。结论:是否长期坚持服用抗血小板药物和降脂药物是影响术后缺血症状复发的相关危险因素。腔内支架成形术后良好的随访及依从性对症状复发可起到预防作用。更多还原

【Abstract】 Objective: Explore the affected lower limb arteriosclerosis occlusion disorder cavity stent angioplasty of postoperative recurrence of lower limb ischemia symptoms related factors.Methods Were retrospectively analyzed in April 2008- April 2014 in urumqi, the xinjiang uygur autonomous region people’s hospital treated 69 cases(70 limb) disease of lower extremity arteriosclerosis occlusion improperness stent angioplasty of postoperative recurrence of lower limb ischemia symptoms in patients with clinical data, Patients with vascular patency rate is obtained by using the life table method, with long- rank test, single factor analysis using the COX model for multiple factors analysis of symptom recurrence.Results: : Line balloon expansion stent implantation after actual followup of 66 cases(69 limb) and were followed up for 6-72 months. In half a year, 1, 3, 5 primary patency rate was 90%,71%, 39%, 31%. Line 2 cases above the ankle amputation, limb salvage rate was 97.1%. Follow-up of 6 cases died.22 cases of postoperative recurrence of symptoms. Single factor analysis showed that after discontinuation of platelet aggregation and lipid-lowering drugs, functional exercise, have an effect on recurrence of symptoms(P <0.05). Multiple factors analysis showed that: postoperative antiplatelet aggregation and lipid drug withdrawal is the independent risk factors influencing the postoperative recurrence of ischemic symptoms(P <0.05).Conclusions: Whether to insist for a long time to antiplatelet drugs and cholesterol-lowering drugs is affect the related risk factors for postoperative recurrence of ischemic symptoms.Cavity after stent good follow-up and adherence to the recurrence of symptoms can be loaded.更多还原