局部动脉灌注治疗雷诺病37例  

Regional intra-arterial infusion for the treatment of Raynaud's disease:a therapeutic analysis of 37 cases

作　　者：李昭辉[1] 徐益鸣[1] 杨东海[1] 刘青[1] 

机构地区：[1]厦门大学附属中山医院血管外科,360014

出　　处：《介入放射学杂志》2011年第1期51-53,共3页Journal of Interventional Radiology

摘　　要：目的观察局部动脉灌注治疗雷诺病的疗效。方法自2005年3月至2010年1月应用局部动脉灌注方法治疗37例内科治疗无效的雷诺病患者。患者病史6个月～5年,平均(38.3±2.7)个月;均以双手发病为主。应用Seldinger技术经股动脉将导管置入肱动脉远端或桡动脉,每侧各推注罂粟碱30 mg、尿激酶10万u、利血平0.5 mg、前列地尔10μg。结果所有37例患者都成功置管和灌注,灌注后双手动脉供血情况立即明显改善。其中18例患者术后完全缓解,随访9个月～4年未复发;6例患者1个月～2年后复发,行第2次动脉灌注治疗,随访1～3年未复发。2例患者效果不明显,经2次动脉灌注治疗,都在治疗数天后原来症状复发。11例患者随访3～6个月后失随访,随访期间没有复发。37例患者平均随访(16.6±4.6)个月,所有病例均未出现穿刺部位和肢体并发症。结论局部动脉灌注治疗内科治疗无效的雷诺病安全、有效。Objective To assess the effectiveness of regional intra-arterial infusion in treating Raynaud＇s disease.Methods From March 2005 to January 2010,regional intra-arterial infusion was carried out in 37 patients with Raynaud＇s disease who had failed to response to internal medication.The patients included 14 males and 23 females with a mean age of 23.4 years（17-26 years）.The course of disease was 6 months to 5 years,with a mean course of（38.3±2.7） months.Both hands were involved when the disease developed.By using Seldinger technique the catheter was inserted into the distal site of brachial artery,or into the radial artery,which was followed by arterial infusion of Nicorandil（30 mg）,Urokinase（100 000u）,Reserpine（0.5 mg） and LipoPGE1（10 ug） for both sides.The clinical results and complications were observed and analyzed.All the patients were followed up for（16±4.6） months.Results The technical success,including catheterization and arterial infusion,was achieved in all 37 patients.After the treatment the blood supply of both hands was remarkably and immediately improved.Of 37 patients,complete relief of ischemic symptoms was seen in 18 with no recurrence during the follow-up period（9 months to 4 years）.Recurrence developed in 6 patients within one month to 2 years after the therapy,arterial infusion was employed again and the patients showed no recurrent symptoms in follow-up time of 1-3 years.Eleven patients lost in touch with the authors 3-6 months after the treatment.The average follow-up period was（16±4.6） months.No procedure-related complications occurred in all 37 patients.Conclusion The regional intra-arterial infusion is an effective and safe treatment for patients with Raynaud＇s disease to whom the conventional internal medication exerts no effect.

关 键 词：雷诺病 动脉灌注治疗 腔内治疗 

分 类 号：R654.4[医药卫生—外科学]