[1]刘源,何春水,廖华强,等.经皮腔内球囊扩张联合动脉内灌注药物治疗慢性下肢缺血[J].介入放射学杂志,2008,(05):332.
LIU Yuan,HE Chunshui,LIAO Huaqiang,et al.Percutaneous transluminal angioplasty combining intraarterial drug perfusion for the treatment of chronic lower limb ischemia[J].journal interventional radiology,2008,(05):332.
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经皮腔内球囊扩张联合动脉内灌注药物治疗慢性下肢缺血(
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]
- 卷:
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- 期数:
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2008年05期
- 页码:
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332
- 栏目:
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血管介入
- 出版日期:
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2008-05-15
文章信息/Info
- Title:
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Percutaneous transluminal angioplasty combining intraarterial drug perfusion for the treatment of chronic lower limb ischemia
- 作者:
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刘源; 何春水; 廖华强; 等
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６１００７２成都中医药大学附属医院血管外科（刘源、何春水、廖华强、曾伟、张宏伟、刘洋、牟艳）、放射科（廖华强）；四川大学生物治疗国家重点实验室（官泳松）
- Author(s):
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LIU Yuan; HE Chun－shui ; LIAO Hua－qiang; ZENG Wei; ZHANG Hong－wei; LIU Yang; MOU Yan; GUAN Yong－song
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Vascular Surgery and Interventional Treatment Center，Affiliated Hospital，Chengdu University of Traditional Chinese Medicine，Chengdu６１００７２，China
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- 关键词:
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经皮腔内球囊扩张; 动脉内药物灌注; 慢性下肢肢体缺血
- 分类号:
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R５４３.５
- 文献标志码:
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A
- 摘要:
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目的临床观察球囊扩张联合动脉内灌注药物治疗慢性下肢缺血的近期疗效。方法慢性下肢缺血患者２１例，采用经股或腋动脉入路，先用球囊扩张闭塞段血管，然后经导管向动脉内灌注尿激酶、前列腺素E
１
、银杏叶注射液。胫腓动脉闭塞的部分患者保留血管鞘，经鞘灌注上述药物，每日１次，共５～７d。术后观察患肢缺血症状、皮肤溃疡和趾端坏疽的改善情况。结果２１例中２０例成功实现经皮经腔球囊扩张和动脉内灌注药物治疗，技术成功率９５．２％。无严重并发症。其中５例患者术后保留血管鞘，灌注药物５～７d后复查造影，显示经球囊扩张后血管腔保持通畅。术后２０例患者均出现诸如患肢皮温升高、间歇性跛行消失、静息痛减轻或消失等临床症状改善情况；随访２～７个月，４例皮肤溃疡愈合，２例坏死足趾脱落，创面愈合，已坏疽的足趾均变干燥，坏死范围停止扩大，未出现需截肢现象。结论经皮腔内球囊扩张联合动脉内灌注尿激酶、前列腺素E
１
、银杏叶注射液治疗慢性下肢缺血安全有效，能够改善肢体缺血症状，促进溃疡愈合，阻止病变发展；保留血管鞘连续灌注药物有助于保持扩张后的血管通畅。
参考文献/References:
［１］Dick F，Diehm N，Galimanis A，et al．Surgical or endovascular revascularization in patients with critical limb ischemia：influence of diabetes mellitus on clinical outcome ［J］．J Vasc Surg，２００７，４５：７５１－７６１．
［２］Conrad MF ，Cambria RP，Stone DH，et al．Intermediate results of percutaneous endovascular therapy of femoropopliteal occlusive disease：a contemporary series［J］．J Vasc Surg，２００６，４４：７６２－７６９．
［３］Faglia E，Mantero M，Caminiti M，et al．Extensive use of perip－heral angioplasty，particularly infrapopliteal，in the treatment of ischemic diabetic foot ulcers：clinical results of a muticentric study of２２１consecutive diabetic subjects［J］．J Int Med，２００２，２５２：２２５－２３２．
［４］Cho SK，Do YS，Shin SW，et al．Subintimal angioplasty in the treatment of chronic lower limb ischemia［J］．Korean J Radiol，２００６，７：１３１－１３８．
[５]Jmsén TS，Manninen HI ，Jaakkola PA，et al．Long－term outcome of patients with claudication after balloon angioplasty of the femoropopliteal arteries［J］．Radiology，２００２，２２５：３４５－３５２．
［６］Schillinger M，Sabeti S，Loewe C，et al．Balloon angioplasty versus implantation of nitinol stentsin the superficial femoral artery［J］．N Engl J Med，２００６，３５４：１８７９－１８８８．
［７］Schillinger M，Sabeti S，Dick P，et al．Sustained benefit at２years of primary femoropopliteal stenting compared with balloon angioplasty with optional stenting［J］．Circulation，２００７，１１５：２７４５－２７４９．
［８］方淳，李明华，程英升，等．糖尿病足截肢前后血管内介入治疗临床分析［J］．介入放射学杂志，２００６，１５：３９０－３９２．
［９］Spinosa DJ ，Leung DA，Matsumoto AH，et al．Percutaneous intentional extraluminal recanalization in patients with chronic critical limb ischemia［J］．Radiology，２００４，２３２：４９９－５０７．
［１０］庄百溪，杨淼，马鲁波，等．小口径球囊经皮腔内血管成形术治疗下肢远端严重肢体缺血２８例报告［J］．中国微创外科杂志，２００７，７：６１５－６１６，６２４．
［１１］许伟，祖茂衡，徐浩，等．早中期动脉阻塞病变综合介入诊疗疗效与影响因素［J］．介入放射学杂志，２００６，１５：１０８－１０９．
备注/Memo
- 备注/Memo:
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收稿日期：２００７－８－１６
更新日期/Last Update:
2008-05-15