【摘要】 目的:探讨股动脉介入置管保留尿激酶、丹参及山莨菪碱治疗糖尿病足的临床应用价值。方法:30例糖尿病足患者,随机分为保守治疗组(对照组,15例)和介入置管保留治疗组(治疗组,15例)。对照组在合理饮食、控制血糖、抗炎及营养神经等治疗基础上,对坏疽局部采用蚕食的方法进行清创,根据坏疽的肉芽生长情况局部应用去腐或生肌中药膏剂外敷,促进肉芽组织生长。治疗组在上述治疗基础上,采用Se ld inger穿刺术对患侧下肢动脉行下肢动脉数字减影(DSA)造影,确定病变范围后介入置管保留,每日经导管动脉脉冲式给予尿激酶50~100 kU,复方丹参20~40 m l,山莨菪碱20~40 m g,最后肝素0.2 m l封管,疗程1~3周。术后常规全身抗凝治疗,6个月后复查下肢血管造影。结果:介入置管保留给药治疗组的总有效率为86.7%,而对照组为53.3%,差异有显著性(P<0.05);介入治疗可以改善糖尿病足下肢动脉的血液灌注,缩短溃疡愈合时间及住院时间。同时,通过合理饮食、控制血糖、抗炎、营养神经和改善血液循环及局部清创应用中药膏剂外敷等综合治疗,其治疗的近期效果令人满意,无严重并发症发生。结论:股动脉介入置管保留尿激酶、丹参及山莨菪碱治疗糖尿病足可获得满意的临床效果,大大降低病残率。更多还原

【Abstract】 Objective: To explore the clinical value of application of interventional therapy with(urokinase),salvia miltiorrhiza injection and anisodamine via femoral artery catheter for diabetic foot ulcer.(Methods): Thirty diabetic patients with foot ulcers were examined by lower extremity digital subtraction(arteriography)(DSA) with simultaneous ultrasonic Doppler examination for correlative study,and were(randomly)(divided) into interventional treatment group(n=15) and conventional treatment group((n=15)).The(patients) in conventional treatment group were treated with appropriate diet,blood sugar control,(anti-infection),nervous nutrition,etc.Additionally,the ulcer tissues were cleaned,and a traditional Chinese medical ointment that has the action of removing necrotic tissues and promoting granulation was used for(external)[HJ*2/5] application to promote granulation.In the patients of intervention treatment group,on the basis of(the therapy) of conventional treatment group,DSA was performed at the artery of abnormal lower extremity(by seldinger) techneque to ensure the site of illness,and then a catheter was implanted in the artery for(administration) of urokinase(50-100 kU),salvia miltiorrhiza(20-40 ml) and anisodamine (20-40 mg),(then)(0.2 ml) of heparin was used to seal the catheter.The therapeutic course was 1-3 weeks.(Anti-coagulative)(treatment) was used conventionally after operation,and DSA was re-performed after(6 months).(Results): The total effective rate of interventional treatment group was 86.7%,and it was 53.3% in conventional treatment group.Interventional therapy by implanting catheter in femoral artery for diabetic foot ulcer could improve the blood circulation of lower extremity,decrease the times of healing and(hospitalization),and the effects of(conventional) treatment group were markedly satisfactory.No serious(complications) were observed.(Conclusion): Use of interventional therapy of urokinase,salvia miltiorrhiza(injection) and anisodamine via(femoral)(artery) catheter for diabetic foot ulcer may result in satisfactory(clinical)(effects) and reduce disability.更多还原