TurboHawk经皮机械斑块切除术与PTA+支架置入术治疗短段股浅动脉硬化闭塞的效果比较

doi:10.3969/j.issn.1006-6233.2026.01.015

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摘要 目的: 分析TurboHawk经皮机械斑块切除术与血管成形术(PTA)+支架置入术治疗短段股浅动脉硬化闭塞症(arteriosclerosis obliterans,ASO)疗效及对术后一期通畅率和复发的影响。方法: 选择本院于2022年3月至2023年9月期间收治的122例短段股浅ASO患者,采用分层随机化分组法其分为对照组(n=61,行PTA联合支架置入术进行治疗)和观察组(n=61,行TurboHawk经皮机械斑块切除术联合PTA+支架置入术)。对照组使用PTA+支架置入术进行治疗,观察组在对照组基础上使用TurboHawk经皮机械斑块切除术进行治疗。观察对照组和观察组短段股浅ASO患者的技术成功率、一期通畅率、血流动力学参数[股浅动脉血流量、踝-肱指数(ABI)、搏动指数(PI)、阻力指数(RI)]、血浆学指标[内皮素1(ET1)、脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)、纤维蛋白原(FIB)]、视觉模拟疼痛评分(VAS)、复发及术后主要不良事件(MAE)发生情况。结果: 两组患者技术成功率均为100%(61/61),差异无统计学意义(P>0.05);观察组患者技术成功率高于对照组,差异有统计学意义(P<0.05);在术后6个月时,观察组股浅动脉血流量、ABI及一期通畅率水平高于对照组,PI、RI、Vaspin、FIB低于对照组,差异均有统计学意义(P<0.05);且观察组术后1周、术后6个月ET1水平均低于对照组,差异均有统计学意义(P<0.05);观察组术后即刻、出院前VAS均低于对照组,差异均有统计学意义(P<0.05);观察组术后6个月内MAE发生率低于对照组,差异有统计学意义(P<0.05)。结论: 使用TurboHawk经皮机械斑块切除术与PTA+支架置入术治疗短段股浅ASO的疗效突出,可以提高技术成功率和一期通畅率,改善血流动力学指标,加快术后疼痛缓解,并预防MAE发生及ASO复发,有利于改善短段股浅ASO患者预后。

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关键词 ：短段股浅动脉硬化闭塞, TurboHawk经皮机械斑块切除术, 血管成形术, 支架置入术, 一期通畅率

Abstract：Objective: To analyze the efficacy of TurboHawk percutaneous mechanical plaque resection and angioplasty (PTA) + stent implantation in the treatment of short-segment superficial femoral arteriosclerosis obliterans (ASO) and its influence on postoperative primary patency rate and recurrence. Methods: A total of 122 patients with short-segment superficial femoral ASO in the hospital from March 2022 to September 2023 were selected and divided into control group (n=61, PTA combined with stent implantation) and observation group (n=61, TurboHawk percutaneous mechanical plaque resection combined with PTA + stent implantation) with the stratified randomization method. The control group was treated with PTA + stent implantation, while the observation group was additionally treated with TurboHawk percutaneous mechanical plaque resection on the basis of the control group. The technical success rate, primary patency rate, hemodynamic parameters [superficial femoral artery blood flow, ankle-brachial index (ABI), pulsatility index (PI), resistance index (RI)], plasma parameters [endothelin 1 (ET1), visceral adipose tissue-derived serine protease inhibitor (Vaspin), fibrinogen (FIB)], visual analogue pain score (VAS), recurrence and postoperative major adverse events (MAE) were observed in both groups. Results: The technical success rates in the groups of patients were both 100% (61/61) (P>0.05). The technical success rate in observation group was significantly higher than that in control group (P<0.05). At 6 months after surgery, the superficial arterial blood flow, ABI and primary patency rate in observation group were higher while PI, RI, Vaspin and FIB were lower than those in control group (P<0.05). The ET1 level in observation group was lower than that in control group at 1 week and 6 months after surgery (P<0.05). VAS in observation group immediately after surgery and before discharge was significantly lower than that in control group (P<0.05). The incidence rate of MAE within 6 months after surgery in observation group was lower than that in control group (P<0.05). Conclusion: The application of TurboHawk percutaneous mechanical plaque resection and PTA + stent implantation has significant efficacy in the treatment of short-segment superficial femoral ASO, and it can enhance the technical success rate and primary patency rate, improve the hemodynamic indicators, accelerate the postoperative pain relief, and prevent MAE and ASO recurrence, and it is conducive to significantly improving the prognosis of patients with short-segment superficial femoral ASO.

Key words： Short-segment superficial femoral arteriosclerosis obliterans TurboHawk percutaneous mechanical plaque resection Angioplasty Stent implantation Primary patency rate

基金资助:陕西省自然科学基础研究计划项目,(编号:2020JQ-555)

通讯作者: 马建仓

引用本文:

李宗禹, 关昊, 赖婧玥, 张莹, 马建仓. TurboHawk经皮机械斑块切除术与PTA+支架置入术治疗短段股浅动脉硬化闭塞的效果比较[J]. 河北医学, 2026, 32(1): 92-99.
LI Zongyu, GUAN Hao, LAI Jingyue, et al. Comparison of the Efficacy of TurboHawk Percutaneous Mechanical Plaque Resection and PTA with Stent Implantation in Treating Short-Segment Superficial Femoral Arteriosclerosis Obliterans. HeBei Med, 2026, 32(1): 92-99.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2026.01.015 或 http://www.hbyxzzs.cn/CN/Y2026/V32/I1/92

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