【摘要】 【目的】观察丹参注射液联合介入治疗对膝下动脉缺血患者的疗效和预后。【方法】回顾性分析150例膝关节以下动脉闭塞患者(176条患肢)采用介入球囊扩张术治疗,术后给予丹参注射液静脉滴注,观察患者治疗前后下肢主要症状和体征、血管再通后通畅情况和踝肱指数(ABI)等的变化情况,并评价联合治疗的效果。【结果】(1)介入球囊扩张治疗的手术成功率为95.8%,患者截肢率为1.3%, 6个月后彩超结果提示远期血管通畅率为89.0%。(2)术后随访6个月显示:手术成功的147例患者中,疗效显著81例,好转57例,无效3例,恶化2例,总有效率为93.4%;术前15例溃疡患者术后13例愈合,2例患者介入成功后因合并感染未控制,病情恶化而截肢。(3)治疗后,患者的皮肤冷感、肢体麻木、酸胀、灼热疼痛、皮肤色泽、间歇性跛行、坏疽、溃疡、足背动脉搏动、静息痛等主要临床症状和体征的积分差值均较治疗前明显改善,差异均有统计学意义(P<0.05)。(4)介入成功的173条患肢术前的ABI平均值为0.23,术后1个月内为0.90,术后1个月内患者ABI平均值较术前升高了0.68,术前与术后比较,差异有统计学意义(P<0.01)。【结论】丹参注射液联合介入治疗对膝下动脉闭塞患者是一种有效治疗方法,具有预后好、并发症少的优点,可避免部分患者截肢。更多还原

【Abstract】 Objective To observe the therapeutic efficacy and prognosis in patients with inferior genicular artery ischemia treated with Danshen(Radix Salviae Miltiorrhizae) Injection combined with interventional therapy.Methods A retrospective analysis was carried out in 150 patients with inferior genicular artery occlusion(involving 176 lower limbs)which have treated with interventional balloon dilatation and then were treated with Danshen Injection after operation. Before and after treatment, the main symptoms and signs of lower limbs, vascular patency rate and ankle brachial index(ABI)after revascularization were analyzed so as to confirm the effect of the combined treatment. Results(1)The success rate of interventional balloon dilatation for the patients was 95.8%,and the amputation rate was 1.3%. After 6 months,color Doppler ultrasound showed that the vascular patency rate was 89.0%.(2)The post-operative follow-up for 6 months showed that in the 147 cases of successful operation,81 were markedly effective,57 effective,3 ineffective,2 deteriorated,and the total effective rate was 93.4%. In 15 patients with ulcers before operation,the ulcers were cured in 13 cases,but 2 cases of successful operation had the amputation for failing in the control of complicated infection.(3)After treatment, the scores of main symptoms and signs of lower limbs such as the sensation of cold in the skin,limb numbness,sore and heavy limb,burning pain,skin color,intermittent claudication,gangrene,pulsation of dorsalis pedis artery,and rest pain were much improved, and the differences were significant(P < 0.05 compared with those before treatment).(3)The mean ABI of the 173 affected limbs before operation was 0.23,and was 0.90 one month after treatment,being increased by 0.68. The difference of ABI before and after treatment was significant(P<0.01).Conclusion Danshen Injection combined with interventional therapy is an effective method for patients with inferior genicular artery occlusion. It can achieve good prognosis,has fewer complications and can avoid amputation.更多还原