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말초동맥질환의 진단과 치료

Diagnosis and Treatment of Peripheral Arterial Disease

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초록

말초동맥질환은 관상동맥과 대동맥을 제외한 전신의 말초동맥에 발생하는 폐색질환으로 신체 전반에 걸쳐 동맥경화증이 진행되고 있음을 의미한다. 말초동맥질환의 가장 흔한 형태인 간헐적 파행이 심한 하지허혈로 진행하는 경우는 드물다. 그러나 말초동맥질환이 있는 환자는 다른 심혈관질환을 동반하는 경우가 많고, 심근경색이나 뇌졸중과 같은 치명적, 비치명적 심혈관사건이 발생할 위험이 매우 높기 때문에 오히려 이러한 요인들이 예후를 결정하게 된다. 따라서 일차 진료를 담당하는 의사는 관상동맥질환이나 다른 심혈관계 질환과 마찬가지로 말초동맥질환에 관심을 가지고 진단할 수 있어야 하며, 이를 진단한 경우에는 적극적인 이차예방을 통해 허혈성 심혈관사건의 발생을 효과적으로 낮추어야 한다. 장비를 이용한 발목-상완지수의 측정은 고위험군에서 말초동맥질환을 선별하거나 말초동맥질환을 진단하는데 있어 매우 유용한 방법이다. 말초동맥질환 환자에서 치료전략은 교정이 가능한 심혈관계 위험인자들을 적극적으로 조절하는데 초점을 맞추어야 하며, 이러한 방법은 장기적인 사망위험을 낮추는데 결정적인 역할을 한다. 반면 수술적 치료는 증상이 매우 심하거나 심한 하지허혈이 있는 환자에 국한해서 시행할 수 있다.

참고문헌 (21)

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