动静脉泵对糖尿病足患者的临床治疗研究  

Effect of Arteriovenous Pump in Patients with Diabetic Foot

作　　者：孙永新[1] 赵迎娱[1] 刘宁[1] 李彬[1] 

机构地区：[1]中国医科大学附属第一医院康复科,沈阳110001

出　　处：《中国医科大学学报》2010年第11期933-935,共3页Journal of China Medical University

基　　金：辽宁省教育厅高校科研基金资助项目(2008842)

摘　　要：目的探讨动静脉泵对糖尿病足患者的腘血流动力学影响及其机制。方法病程在1～3年的50岁以上的糖尿病足患者36例(患肢38条),随机分为2组,对照组16例,每日静脉滴注0.9%生理盐水250 ml和复方丹参液40 ml;实验组20例,复方丹参液联合应用动静脉足泵治疗,1周为1个疗程,连续治疗3个疗程。结果实验组和对照组在治疗3周后每组约90%的患足皮肤紫绀、冷感、足痛等症状皆明显改善或症状消失。实验组患肢的踝肱指数(ABI)、趾臂指数(TBI)治疗后与治疗前相比均明显升高(P<0.01)。相对对照组,实验组患肢的腘动脉血流动力学参数,除腘动脉直径(DIA)外,腘动脉收缩期平均容积流量(SVOF)、舒张期平均容积流量(DVOF)、腘动脉收缩期峰速度(TSV)、腘舒张末期速度(EDV)治疗后均比治疗前增加显著(P均<0.01)。结论动静脉泵治疗能够明显改善糖尿病足患者患肢的症状和腘动脉血流动力学改变,其主要机制为增加下肢外周动脉血流量,提高动静脉血流回流速度,促进侧支循环重建,改善足部微循环,防止血栓形成。Objective To study the effect of arteriovenous pump on popliteal artery hemodynamics in patients with diabetic foot.Methods A total of 36 patients（38 affected limbs）with diabetic foot who were aged 50 years and older and with a disease course of 1 to 3 years were randomly divided into 2 groups.The patients in control group（n =16）were injected intravenously with 250 ml of 0.9% normal saline and 40 ml of composite salvia miltiorrhiza injection.The patients in experimental group（n =20）were treated with composite salvia miltiorrhiza injection and arteriovenous pump for 3 courses（1 week each course）.Results The symptoms in 90% of the affected foot were alleviated or disappeared in both experimental group and control group.In experimental group,ankle-brachial index and toe-brachial index significantly increased after treatment.Compared with control group,hemodynamic parameters of popliteal artery including systolic volume flow,diastolic volume flow,time-to-peak systolic velocity,and end diastolic velocity after treatment significantly increased in experimental group（all P 0.01）.Conclusion Arteriovenous pump could improve the symptoms and popliteal artery hemodynamics of patients with diabetic foot,mainly by increasing the blood flow,promoting the development of collateral circulation,and improving the microcirculation.

关 键 词：糖尿病足 动静脉泵 复方丹参液 腘动脉血流动力学 

分 类 号：R454.4[医药卫生—治疗学]