General Surgery, The First People's Hospital of WenLing, No. 333, Chuanan Road, Wenling City, 317500 Zhejiang Province, China.
Comput Math Methods Med. 2022 Aug 4;2022:9190292. doi: 10.1155/2022/9190292. eCollection 2022.
This study was designed to analyse the clinical efficacy of interventional therapy on lower extremity arteriosclerosis obliterans (LEASO) and prognostic factors.
A total of 122 patients with LEASO diagnosed in our hospital from March 2017 to March 2019 were retrospectively analysed. Among them, 72 patients who received conservative therapy were assigned to a conservative group, and 50 patients who received interventional therapy additionally based on conservative therapy were assigned to an intervention group. The short-term (12 weeks after therapy) and long-term (3 years after therapy) clinical efficacies on the two groups were compared. Death, amputation, and vascular restenosis (vascular stenosis > 50% in computed tomography reexamination) were defined as unfavourable outcomes, and Cox regression was conducted to analyze the factors influencing the prognosis of patients. The incidence of adverse events in the two groups within 3 years was compared and statistically analyzed. Additionally, the hospital stay, therapy cost, claudication distance, and ankle brachial index were compared between the two groups.
After therapy, the conservative group showed a notably lower total effective rate than the intervention group ( < 0.05), but the clinical efficacy after 3 years was similar between the two groups ( > 0.05). Additionally, the conservative group experienced notably longer hospital stay than the intervention group ( < 0.05), and cost less in treatment than the intervention group ( < 0.05). However, the conservative group experienced a notably shorter claudication distance and showed a notably lower ankle brachial index than the intervention group ( < 0.05). The two groups were not significantly different in mortality, amputation rate, and vascular restenosis rate ( > 0.05). Moreover, Cox regression analysis revealed that age and conservative therapy were independent risk factors for the prognosis of patients ( < 0.05).
Interventional therapy can substantially improve the short-term efficacy and prognosis of patients with LEASO, but the cost is high, so the therapeutic regimen should be selected according to the patient's economic condition.
本研究旨在分析介入治疗下肢动脉硬化闭塞症（LEASO）的临床疗效及其预后因素。
回顾性分析 2017 年 3 月至 2019 年 3 月我院收治的 122 例 LEASO 患者，其中接受保守治疗的 72 例患者分为保守组，在保守治疗的基础上额外接受介入治疗的 50 例患者分为介入组。比较两组患者短期（治疗后 12 周）和长期（治疗后 3 年）的临床疗效。死亡、截肢和血管再狭窄（计算机断层复查血管狭窄>50%）定义为不良结局，并采用 Cox 回归分析影响患者预后的因素。比较两组患者 3 年内不良事件的发生率并进行统计学分析。同时比较两组患者的住院时间、治疗费用、跛行距离和踝肱指数。
治疗后，保守组总有效率明显低于介入组（<0.05），但两组 3 年后的临床疗效相似（>0.05）。此外，保守组的住院时间明显长于介入组（<0.05），治疗费用明显低于介入组（<0.05）。但保守组的跛行距离明显短于介入组，踝肱指数明显低于介入组（<0.05）。两组患者的死亡率、截肢率和血管再狭窄率差异无统计学意义（>0.05）。Cox 回归分析显示，年龄和保守治疗是影响患者预后的独立危险因素（<0.05）。
介入治疗可显著提高 LEASO 患者的短期疗效和预后，但费用较高，因此应根据患者的经济状况选择治疗方案。
