前列地尔联合介入治疗对糖尿病足的临床疗效观察.docVIP

· 2548 · · 专 题 研 究 · 前列地尔联合介入治疗对糖尿病足的临床疗效观察 王卫东，刘伦琴，邢林 【摘要】 目的 观察前列地尔联合介入治疗对糖尿病足的临床疗效。方法 按1999年世界卫生组织制定的糖 尿病诊断标准，所有患者在数字减影血管造影 (DSA) 下行双下肢血管造影，参照泛大西洋协作组共识 (TASC) 股、 胭动脉的分级标准，符合其中的A、B 级；按照糖尿病足Wagner分级4级及以下，共收治85例糖尿病足患者，将患者 分为介入治疗组(45例)和传统治疗组(40例)。介入治疗组根据血管状况采取球囊扩张、支架成形术、内膜下血管 成形术等方法进行治疗，术后给予前列地尔40 μg 静脉滴注，1次/d, 治疗3周。传统治疗组给予静脉改善微循环、口 服抗凝等药物治疗。观察溃疡处颜色、肉芽组织生长情况、溃疡深度变化，观察足部感觉变化和患者自觉症状改善情 况，用彩色多普勒超声检查双侧足背动脉内径、血流速度恢复情况。结果 治疗后介入治疗组患者有效率为88.9% (40/45),传统治疗组有效率为62.5%(25/40),两组有效率间差异有统计学意义 (P0.01)。 治疗后介入治疗组患 者足背动脉内径及血流速度与传统治疗组比较，差异有统计学意义 (P0.05)。 结论 前列地尔联合介入治疗能提高 糖尿病足治疗有效率，扩大足背动脉内径，加快足背动脉血流速度。 【关键词】 前列地尔；介入治疗；糖尿病足；治疗结果 【中图分类号】 R587.29 【文献标识码】 A 【文章编号】1007-9572(2010)08-2548-04 Clin ical Therapeutic Outcome of Alprostadil Combined with Interventional Therapy in Sufferers of Diabetic Foot WANG Wei-dong,LIU Lun -qin, XING Lin. Third Hospital of Jinan City,Jinan 250101,China 【Abstract] Objective To observe the clinical therapeutic outcome of alprostadil combined with interventional therapy in sufferers of diabetic foot(DF). Methods All patients had lower extremities CT angiography with DSA according to Diagnos- tic Norm of Diabetes Stipulated by WHO in 1999,consistent with grading A, B of TASC Femoral and Popliteal Artery Grading. A total of 85 DF patients were divided into groups intervention(n =45)and traditional therapy(n =40). Intervention group were treated by balloon catheter technique, stent plasty, subintimal angioplasty, etc. and with alprostadil, iv gtt, once/d, 3 weeks. Traditional therapy group given intravenous microcirculation improving drugs and oral anti - coagulation. Ulcer color, granulation growth, ulcer depth change,changes of foot sensation and subjective symptom improvement were observed. Bilateral dorsal artery diameter and blood flow recovery detected by color Doppler. Results The effective rate was 88.9%(40/45)in intervention group, and 62.5%(25/40)in traditional therapy group after treatment,the difference was signi