| Objective To investigate the clinical effect of catheter thrombolysis combined with multiple endovascular interventionsin the treatment of patients with lower extremity arteriosclerosis obliterans (ASO).Methods The clinical data of lower extremity ASOpatients admitted to Nanyang Central Hospital from May 2017 to May 2019 were retrospectively analyzed. Forty-eight patients who un-derwent direct endovascular intervention were selected as the control group, and the 48 patients who underwent endovascular interven-tion after catheter thrombolysis were selected as the observation group. The clinical symptoms [foot skin temperature, toe oxygen satura-tion (SO2), ankle-brachial index (ABI), visual analog scale (VAS)], dorsal artery hemodynamic indexes (vascular diameter, blood flowvolume, blood flow peak velocity) and lower extremity nerve conduction velocity (motor nerve conduction velocity, sensory nerve con-duction velocity) changes of the two groups of patients before and after surgery were observed, and the therapeutic effects (stent place-ment rate, amputation rate, complication rate) and clinical observation indicators (operation time, postoperative hospital stay) were com-pared between the two groups.Results One month after operation, the skin temperature of the feet of the patients [(16.25±2.17)℃ vs. (27.67±3.27)℃, (15.81±2.41)℃ vs. (26.84±3.56)℃], toe SO2 [(25.31±5.64)% vs. (87.16±8.3)%, (24.71±5.97)% vs. (85.64±6.84)%] and ABI [(0.23±0.10) vs. (0.83±0.12), (0.25±0.09) vs. (0.85±0.11)] in the observation group and the control group were higher than those be-fore operation (P < 0.05); the VAS score [(7.15±1.62) points vs. (0.98±0.16) points, (7.02±1.59) points vs. (1.02±0.15) points] and blood flow peak velocity [(51.67±9.23) cm/s vs. (40.75±7.19) cm/s, (52.64±8.71) cm/s vs. (41.62±7.62) cm/s] were lower than those before op-eration (P < 0.05); the vascular diameter, blood flow volume, lower extremity motor nerve conduction velocity and sensory nerve conduc-tion velocity were higher than those before operation (P < 0.05). The stent placement rate and amputation rate were 16.67% (8/48) and 2.08% (1/48), respectively, in the observation group, which were lower than those in the control group, which were 43.75% (21/48) and16.67% (8/48) (P < 0.05); The operation time [(2.05±0.56) h vs (4.12±1.03) h] and postoperative hospital stay [(10.32±2.45) d vs(15.18±3.17) d] were shorter than those in the control group, respectively (P < 0.05). There was no significant difference in the inci-dence of complications among patients (P > 0.05).Conclusions Catheter thrombolysis combined with multiple endovascular interven-tions and single endovascular intervention for lower extremity ASO can effectively improve the clinical symptoms of patients, increasethe blood flow volume of the dorsal artery and the lower extremity nerve conduction velocity, and have few complications. Catheterthrombolysis can reduce stent placement and amputation, with low time cost and high clinical value. |
