外周动脉疾病血运重建手术提高功能效率和生活质量:客观指标和主观指标的比较分析。

Anna Nowaczyk, Justyna Cwajda-Białasik, Arkadiusz Jawień, Maria Teresa Szewczyk
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摘要

背景本研究旨在比较波兰一家中心98名诊断为外周动脉疾病(PAD)的患者在血运重建术前和术后3个月的踝臂指数(ABI)、最大跛行距离(MCD)、无痛步行距离(PFWD)、跛行疼痛和生活质量(间歇性跛行问卷[ICQ])。材料和方法98例患者(77%男性,23%女性,65.65±7.27岁)被诊断为PAD,符合血运重建条件。PAD的诊断依据ABI≤0.9和病历。患者接受了非侵入性检查,包括ABI的测量(通过EZ8探针的多普勒)、ICQ的生活质量评估、使用Gardner Skinner方案在跑步机上间歇性跛行的距离(包括PFWD和MCD)以及行走过程中的疼痛强度(数字评定量表[NRS11])。评估分两次进行:手术前1至5天和手术后3个月。结果ABI升高(0.4比0.62,P
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Enhancing Functional Efficiency and Quality of Life through Revascularization Surgery in Peripheral Arterial Disease: A Comparative Analysis of Objective and Subjective Indicators.

BACKGROUND This study aimed to compare the ankle-brachial index (ABI), maximal claudication distance (MCD), pain-free walking distance (PFWD), claudication pain, and quality of life (intermittent claudication questionnaire [ICQ]) before and 3 months after revascularization surgery in 98 patients diagnosed with peripheral arterial disease (PAD) at a single center in Poland. MATERIAL AND METHODS Ninety-eight patients were examined (77% men, 23% women, 65.65±7.27 years old), diagnosed with PAD, and qualified for revascularization. The diagnosis of PAD was made on the basis of ABI ≤0.9 and medical records. The patients underwent a noninvasive examination, including measurement of ABI (by Doppler with the EZ8 probe), assessment of the quality of life by ICQ, distance of intermittent claudication on a treadmill using the Gardner-Skinner protocol (including PFWD and MCD), and pain intensity during walking (numeric rating scale [NRS11]). The assessment was carried out twice: 1 to 5 days before surgery and 3 months after surgery. RESULTS There was an increase of ABI (0.4 vs 0.62, P<0.001), PFWD (26.64 vs 80.21, P<0.001), MCD (60.08 vs 181.85, P<0.001), and ICQ (79.92 vs 60.23, P<0.001) and reduction of PFWD pain (7.26 vs 6.05, P<0.001) and MCD pain (9.24 vs 8.11, P<0.001). CONCLUSIONS Revascularization surgery improved the ABI and patients functional efficiency expressed in the improvement of subjective indicators PFWD, MCD, NRS11, and ICQ. Patients who had a longer duration of disease had worse outcomes after revascularization. More attention should be paid to increasing access to preventive examinations aimed at early detection of PAD and the possibility of implementing conservative treatment.

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