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解放军总医院医学创新研究部、国家老年疾病临床医学研究中心(解放军总医院)、解放军总医院第六医学中心心血管病医学部
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
李立强,佟铸,崔世军,郭建明,郭连瑞.股总动脉内膜剥脱术后再狭窄的影响因素[J].中华老年多器官疾病杂志,2022,21(8):576~580
股总动脉内膜剥脱术后再狭窄的影响因素
Influencing factors of restenosis after common femoral artery endarterectomy
投稿时间:2022-02-15  
DOI:10.11915/j.issn.1671-5403.2022.08.124
中文关键词:  股总动脉内膜剥脱术;危险因素;糖尿病;吸烟;膝下流出道
英文关键词:common femoral endarterectomy; risk factor; diabetes mellitus; smoking; below-the-knee run-offs This work was supported by Clinical Medicine Development of Special Funding of Beijing Municipal Administration of Hospitals
基金项目:北京市医院管理局临床医学发展专项经费资助(XMLX201836);宣武医院医院国自然青年培育项目(QNPY2021038)
作者单位E-mail
李立强 首都医科大学宣武医院血管外科,北京 100053 guolianrui@xwhosp.orginfluencing 
佟铸 首都医科大学宣武医院血管外科,北京 100053 guolianrui@xwhosp.orginfluencing 
崔世军 首都医科大学宣武医院血管外科,北京 100053 guolianrui@xwhosp.orginfluencing 
郭建明 首都医科大学宣武医院血管外科,北京 100053 guolianrui@xwhosp.orginfluencing 
郭连瑞 首都医科大学宣武医院血管外科,北京 100053 guolianrui@xwhosp.orginfluencing 
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中文摘要:
      目的 探讨股总动脉硬化闭塞症患者行股总动脉内膜剥脱术后发生再狭窄的相关影响因素。方法 回顾性分析2011年1月至2019年9月于首都医科大学宣武医院血管外科行股总动脉内膜剥脱术的136例患者为研究对象,术后下肢动脉超声检查评估股总动脉再狭窄>70%纳入再狭窄组(n=47),股总动脉再狭窄≤70%纳入通畅组(n=89)。比较股总动脉通畅组和再狭窄组患者的临床资料,使用Cox比例风险回归模型探索股总动脉内膜剥脱术后再狭窄的影响因素。采用SPSS 21.0统计软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ2检验。结果 136例患者术后发生再狭窄47例(34.6%)。股总动脉通畅组和再狭窄组患者合并糖尿病、吸烟情况和低密度脂蛋白胆固醇比较,差异均有统计学意义[30(63.8%)和35(39.3%),29(61.7%)和29(32.6%),(1.79±0.58)和(1.54±0.46)mmol/L;均P<0.05]。2组患者膝下流出道情况比较,差异有统计学意义(P<0.05)。2组患者均于术后1d各发生腹股沟血肿1例,于术后3d各发生局部淋巴漏1例,给予对症处理后均痊愈。Cox比例风险回归模型分析后显示:合并糖尿病(RR =2.339,95%CI 1.273~4.296, P=0.006)、吸烟史(RR=1.931,95%CI 1.063~3.507, P=0.031)及膝下流出道情况(RR=0.412,95%CI 0.217~0.783, P=0.007)和股总动脉内膜剥脱术后发生再狭窄独立相关。结论 患者合并糖尿病、吸烟史是影响股总动脉内膜剥脱术预后的独立危险因素,积极处理膝下流出道可能会降低股总动脉内膜剥脱术后再狭窄的发生率。
英文摘要:
      Objective To investigate the related factors influencing restenosis after common femoral artery endarterectomy (CFAE) in treatment of arteriosclerosis obliterans at common femoral artery (CFA). Methods A total of 136 patients with arteriosclerosis obliterans at CFA who underwent CFAE in our hospital from January 2011 to September 2019 were retrospectively subjected in this study. The patients with restenosis of common femoral artery > 70% were included in the restenosis group (n=47), and those of restenosis≤ 70% in the patency group (n=89). The clinical data were compared between the 2 groups. Cox proportional hazards regression model was used to analyze the influencing factor for restenosis after endarterectomy. SPSS statistics 21.0 was used for statistical analysis. Data comparison between 2 groups was performed using student′s t test or Chi-square test depending on data type. Results Forty-seven of 136 patients (34.6%) suffered from restenosis. There were significant differences in proportions of diabetes and smoking history and level of low-density lipoprotein cholesterol between the patency group and the restenosis group [30 (63.8%) vs 35 (39.3%), 29 (61.7%) vs 29 (32.6%), (1.79±0.58) vs (1.54±0.46) mmol/L, all P<0.05]. Obvious difference was seen in the situation of below-the-knee run-offs between the 2 groups (P<0.05). In both groups, 1 case of inguinal hematoma occurred in 1 d after operation and 1 case of local lymphatic leakage occurred in 3 d after operation. All patients were cured after symptomatic treatment. Results of Cox proportional hazard model showed that diabetes mellitus (RR=2.339,95%CI 1.273-4.296, P=0.006), smoking history (RR=1.931, 95%CI 1.063-3.507, P=0.031) and below-the-knee run-offs (RR=0.412,95%CI 0.217-0.783, P=0.007) were independently related with restenosis after CFAE. Conclusion Comorbidity of diabetes mellitus and smoking history are independent risk factors of restenosis in patients after CFAE. Initiative management of below-the-knee run-offs may reduce the incidence of restenosis.
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