Syngo iFlow評估癥狀性下肢動脈缺血介入腔內(nèi)成形術(shù)前后循環(huán)變化的初步研究
發(fā)布時間：2018-10-10 16:46
【摘要】：目的：探討Syngo iFlow軟件評估下肢動脈癥狀性缺血性疾病腔內(nèi)治療前后患肢血流動力學(xué)改善情況的可行性和準確性,及其與傳統(tǒng)臨床療效評估方法的相關(guān)性。方法：回顧性分析接受介入腔內(nèi)治療40例下肢動脈慢化閉塞癥嚴重下肢缺血患者(男24例,女16例,年齡58-85歲,股胴動脈TASC 11 B／C型病變)病歷資料。收集術(shù)前術(shù)后完整的忠肢循環(huán)狀況的評估資料,包括臨床癥狀體征(疼痛、冷感、跛行)評估、蹀肱指數(shù)(ABI)、經(jīng)皮氧分壓(TcPO2)測量等,評價手術(shù)療效。運用Syngo iFlow對術(shù)前術(shù)后患肢足踝部TTP值進行測量,評價肢端血流動力學(xué)改善情況。采集術(shù)前和術(shù)后的股總動脈分叉部、胭動脈分叉部、踝關(guān)節(jié)水平TTP值以及胭動脈分叉部股總動脈分叉部、踝關(guān)節(jié)水平與胭動脈分叉部之間TTP差值進行統(tǒng)計學(xué)比較。由2名血管介入及影像診斷�？漆t(yī)生采用比較評價DSAjfSyngo iFlow兩種方法顯示血流和灌注變化信息的質(zhì)量。分別采用t檢驗、Wilcixin秩和檢驗Spearman等級相關(guān)分析對資料進行統(tǒng)計學(xué)分析,評價Syngo iFlow口傳統(tǒng)臨床評估方法對腔內(nèi)治療前后患肢循環(huán)改善評估的相關(guān)性及一致性。結(jié)果：40例患者通過腔內(nèi)治療成功修復(fù)股胭動脈段重度狹窄及閉塞病變。術(shù)前傳統(tǒng)臨床方法評估：疼痛評分(1.88±1.62)、冷感評分(2.15±1.25)、跛行評分(2.90±0.84)、ABI(0.35±0.08)、TcPO2(27.39±5.26 )mmHg:術(shù)后1周內(nèi)評估：疼痛評分(0.22±0.42)、冷感評分(0.23±0.42)、跛行評分(0.63±0.59)、ABI(0.66±0.07)、TcP02(40.75±3.42)mmmHg,治療前后差異有統(tǒng)計學(xué)意義(P0.05),顯示患者下肢缺血癥狀均有顯著改善。SyngoiFlow評估：術(shù)前足踝水平點測量TTP值(14.54±1.89)s,術(shù)后足踝水平點測量TTP值(10.40±1.98)s；術(shù)前足踝水平區(qū)域測量TTP值(20.08±3.05)s,術(shù)后足踝水平區(qū)域測量TTP值(16.43±2.52)s,治療前后差異有統(tǒng)計學(xué)意義(P0.05),表明治療后足踝部區(qū)域血流灌注明顯改善。術(shù)前股胭動脈TTP差值和胭踝動脈TTP差值分別為(6.88±1.90)s、 (8.66±1.79)s,術(shù)后股胭動脈TTP差值和胭踝動脈TTP差值分別為(4.()5±1.25)、 (7.82±1.87)s,兩處TTP差值減小治療前后差異有統(tǒng)計學(xué)意義(P0.05),說明治療后血流速度增快。Spearman相關(guān)性分析足躁部點測量ΔTTP和△ ABI、△TcP02之間呈正相關(guān)(r=0.53,0.33,P0.05)：區(qū)域測量△TTP和△ABI、△TcP02之問呈正相關(guān)(r=0.63,0.41,P0.05)。運用Syngo iFlowDSA兩種方法評判血流動力學(xué)變化觀察結(jié)果比較,認為Syngo Flow圖像觀察質(zhì)量較DSA圖像質(zhì)量優(yōu)秀,差異有統(tǒng)計學(xué)意義。結(jié)論：Syngo iFlow軟件可以用來實時量化分析下肢動脈阻塞性疾病血管成形術(shù)前后的血流動力學(xué)變化,其評估結(jié)果與傳統(tǒng)臨床療效評估方法具有一致性。
[Abstract]:Objective: to evaluate the feasibility and accuracy of Syngo iFlow software in evaluating hemodynamic improvement of affected limbs before and after endovascular treatment for lower extremity arterial symptomatic ischemic diseases and its correlation with traditional clinical evaluation methods. Methods: the medical records of 40 patients (24 males, 16 females, 58-85 years old with TASC 11 B / C lesions) with lower extremity slow occlusion treated by interventional intracavitary therapy were retrospectively analyzed. The preoperative and postoperative data were collected to evaluate the clinical symptoms and signs (pain, cold feeling, lameness), and the transcutaneous partial pressure of oxygen (TcPO2) to evaluate the outcome of the operation. Syngo iFlow was used to measure the TTP value of foot and ankle before and after operation to evaluate the improvement of hemodynamics. The TTP values of common femoral artery bifurcation, popliteal artery bifurcation, ankle joint level and popliteal artery bifurcation were collected before and after operation. The TTP difference between the common femoral artery bifurcation and popliteal artery bifurcation was statistically compared between the ankle level and the popliteal artery bifurcation. The quality of blood flow and perfusion information was compared and evaluated by two vascular interventional and imaging diagnostics specialists. T test, Wilcixin rank sum test and Spearman grade correlation analysis were used to evaluate the correlation and consistency of the traditional clinical evaluation method of Syngo iFlow mouth in evaluating the improvement of limb circulation before and after intracavitary treatment. Results: 40 patients successfully repaired severe femoral artery stenosis and occlusion by endovascular treatment. Preoperative evaluation of traditional clinical methods: pain score (1.88 鹵1.62), cold sensation score (2.15 鹵1.25), lameness score (2.90 鹵0.84), ABI (, 0.35 鹵0.08), TcPO2 (27.39 鹵5.26) mmHg:, 1 week after operation: pain score (0.22 鹵0.42), cold feeling score (0.23 鹵0.42), limping score (0.63 鹵0.59), ABI (0.66 鹵0.07), TcP02 (40.75 鹵3.42) mmmHg, before and after treatment (P0.05). SyngoiFlow evaluation showed that TTP value was (14.54 鹵1.89) s at ankle level before operation and TTP was (10.40 鹵1.98) s at ankle level after operation. The TTP value in the ankle area before operation was (20.08 鹵3.05) s, and the TTP value in the ankle area after operation was (16.43 鹵2.52) s. The difference before and after treatment was statistically significant (P0.05), which indicated that the blood perfusion in the ankle area was improved significantly after treatment. Preoperative TTP difference of popliteal artery and popliteal artery TTP difference were (6.88 鹵1.90) s, (8.66 鹵1.79) s, postoperatively, TTP difference of popliteal artery and popliteal artery TTP difference were (4.5 鹵1.25), (7.82 鹵1.87) s, respectively. There was significant difference between the two TTP differences before and after treatment (P0.05). Spearman correlation analysis showed that there was a positive correlation between 螖 TTP and ABI, TcP02 (r = 0.53P = 0.33) and a positive correlation between TTP and ABI, TcP02 (r = 0.63n 0.41 P 0.05). The observation results of hemodynamic changes were evaluated by Syngo iFlowDSA, and the results showed that the quality of Syngo Flow images was better than that of DSA images, and the difference was statistically significant. Conclusion: Syngo iFlow software can be used to quantify the hemodynamic changes before and after angioplasty in patients with lower extremity arterial obstructive disease. The evaluation results are consistent with the traditional clinical evaluation methods.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R654.4;R816.2
本文編號：2262524
[Abstract]:Objective: to evaluate the feasibility and accuracy of Syngo iFlow software in evaluating hemodynamic improvement of affected limbs before and after endovascular treatment for lower extremity arterial symptomatic ischemic diseases and its correlation with traditional clinical evaluation methods. Methods: the medical records of 40 patients (24 males, 16 females, 58-85 years old with TASC 11 B / C lesions) with lower extremity slow occlusion treated by interventional intracavitary therapy were retrospectively analyzed. The preoperative and postoperative data were collected to evaluate the clinical symptoms and signs (pain, cold feeling, lameness), and the transcutaneous partial pressure of oxygen (TcPO2) to evaluate the outcome of the operation. Syngo iFlow was used to measure the TTP value of foot and ankle before and after operation to evaluate the improvement of hemodynamics. The TTP values of common femoral artery bifurcation, popliteal artery bifurcation, ankle joint level and popliteal artery bifurcation were collected before and after operation. The TTP difference between the common femoral artery bifurcation and popliteal artery bifurcation was statistically compared between the ankle level and the popliteal artery bifurcation. The quality of blood flow and perfusion information was compared and evaluated by two vascular interventional and imaging diagnostics specialists. T test, Wilcixin rank sum test and Spearman grade correlation analysis were used to evaluate the correlation and consistency of the traditional clinical evaluation method of Syngo iFlow mouth in evaluating the improvement of limb circulation before and after intracavitary treatment. Results: 40 patients successfully repaired severe femoral artery stenosis and occlusion by endovascular treatment. Preoperative evaluation of traditional clinical methods: pain score (1.88 鹵1.62), cold sensation score (2.15 鹵1.25), lameness score (2.90 鹵0.84), ABI (, 0.35 鹵0.08), TcPO2 (27.39 鹵5.26) mmHg:, 1 week after operation: pain score (0.22 鹵0.42), cold feeling score (0.23 鹵0.42), limping score (0.63 鹵0.59), ABI (0.66 鹵0.07), TcP02 (40.75 鹵3.42) mmmHg, before and after treatment (P0.05). SyngoiFlow evaluation showed that TTP value was (14.54 鹵1.89) s at ankle level before operation and TTP was (10.40 鹵1.98) s at ankle level after operation. The TTP value in the ankle area before operation was (20.08 鹵3.05) s, and the TTP value in the ankle area after operation was (16.43 鹵2.52) s. The difference before and after treatment was statistically significant (P0.05), which indicated that the blood perfusion in the ankle area was improved significantly after treatment. Preoperative TTP difference of popliteal artery and popliteal artery TTP difference were (6.88 鹵1.90) s, (8.66 鹵1.79) s, postoperatively, TTP difference of popliteal artery and popliteal artery TTP difference were (4.5 鹵1.25), (7.82 鹵1.87) s, respectively. There was significant difference between the two TTP differences before and after treatment (P0.05). Spearman correlation analysis showed that there was a positive correlation between 螖 TTP and ABI, TcP02 (r = 0.53P = 0.33) and a positive correlation between TTP and ABI, TcP02 (r = 0.63n 0.41 P 0.05). The observation results of hemodynamic changes were evaluated by Syngo iFlowDSA, and the results showed that the quality of Syngo Flow images was better than that of DSA images, and the difference was statistically significant. Conclusion: Syngo iFlow software can be used to quantify the hemodynamic changes before and after angioplasty in patients with lower extremity arterial obstructive disease. The evaluation results are consistent with the traditional clinical evaluation methods.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R654.4;R816.2
【相似文獻】
相關(guān)期刊論文 前10條
1 韓同;;“搭橋”治療下肢動脈缺血癥[J];健康博覽;1998年11期
2 呂斌;;下肢動脈缺血癥的癥狀及治療[J];老人天地;2004年04期
3 景在平,梅志軍;遠端流出道不良的下肢動脈缺血腔內(nèi)微創(chuàng)治療[J];臨床外科雜志;2004年08期
4 廖文勇;覃鴻尚;;人造血管旁路移植術(shù)治療下肢動脈缺血25例分析[J];華夏醫(yī)學(xué);2006年01期
5 吳麗霞;;自體外周血單個核細胞移植治療下肢動脈缺血的護理[J];中國實用醫(yī)藥;2010年04期
6 郭亞娟;張玉順;馬愛群;;重癥下肢動脈缺血的診治進展[J];陜西醫(yī)學(xué)雜志;2011年06期
7 呂斌;不容忽視的下肢動脈缺血癥[J];長壽;2004年02期
8 景在平;下肢動脈缺血病談[J];開卷有益(求醫(yī)問藥);1996年03期
9 楊博華,秦建輝,朱齡群,陳蕾,路紅,李友山,周笑允;自體骨髓干細胞移植合中藥治療下肢動脈缺血[J];浙江中西醫(yī)結(jié)合雜志;2004年11期
10 張柏根;錢虎聲;;基因治療在處理下肢動脈缺血中的應(yīng)用及前景[J];中國實用外科雜志;1996年09期
相關(guān)會議論文 前3條
1 黃平平;李尚珠;韓明哲;肖志堅;楊仁池;邱錄貴;韓忠朝;;外周血干細胞移植治療下肢動脈缺血[A];第九屆全國實驗血液學(xué)會議論文摘要匯編[C];2003年
2 王曉軍;宋國成;王建寧;張軍;高繼東;殷岳;;自體骨髓祖細胞移植對下肢動脈缺血導(dǎo)致創(chuàng)面中VE-鈣黏附分子的影響[A];第五屆全國燒傷救治專題研討會燒傷后臟器損害的臨床救治論文匯編[C];2007年
3 楊博華;吳魯輝;秦建輝;朱齡群;;自體骨髓單個核細胞移植與中藥合用治療糖尿病下肢動脈缺血[A];全國中西醫(yī)結(jié)合周圍血管病專題研討會論文匯編[C];2005年
相關(guān)重要報紙文章 前3條
1 呂 斌;不可忽視的下肢動脈缺血癥[N];中國中醫(yī)藥報;2003年
2 呂斌;下肢動脈缺血病要盡早手術(shù)[N];大眾衛(wèi)生報;2003年
3 李欣;介入治療助下肢動脈硬化閉塞癥患者保住肢體[N];科技日報;2014年
相關(guān)博士學(xué)位論文 前1條
1 蘇浩波;Syngo iFlow評估癥狀性下肢動脈缺血介入腔內(nèi)成形術(shù)前后循環(huán)變化的初步研究[D];南京醫(yī)科大學(xué);2016年
相關(guān)碩士學(xué)位論文 前2條
1 張海瀟;下肢缺血疾病介入治療的臨床應(yīng)用[D];新疆醫(yī)科大學(xué);2008年
2 景大豪;外源性Intermedin在小鼠下肢動脈缺血模型中的血管生成作用研究[D];山西醫(yī)科大學(xué);2015年
，本文編號：2262524
本文鏈接：http://sikaile.net/yixuelunwen/yundongyixue/2262524.html
最近更新
教材專著
