尿激酶、罂粟碱在糖尿病足血管造影中的临床应用  

Clinical application on urokinase,papaverine angiography in diabetic foot

作　　者：任毅[1] 陈君辉[1] 贺平[1] 

机构地区：[1]成都市第二人民医院介入医学科,四川成都610017

出　　处：《四川医学》2012年第6期1008-1010,共3页Sichuan Medical Journal

摘　　要：目的探讨尿激酶、罂粟碱在糖尿病足血管造影中的临床应用。方法对47例血管多普勒检查提示下肢动脉狭窄且合并下肢缺血表现糖尿病患者,行DSA血管造影后,对其中19例胫、腓动脉中、远段或足部微小动脉狭窄或闭塞患者,经导管采用团注法灌注尿激酶25～50U、罂粟碱30～60mg行溶栓,扩血管治疗。结果 19例经导管灌注尿激酶、罂粟碱患者下肢缺血表现明显改善,并通过内科综合治疗,靶血管周围侧支血管明显增多占全组病例的100%,狭窄段血管腔较前扩张占68%,闭塞段血管重新开通占36.8%。0～Ⅱ级病足溃疡面愈合,Ⅲ～Ⅳ级病足溃疡面干燥、缩小、周围炎症消退。结论动脉内灌注尿激酶、罂粟碱可以一定程度改善下肢血液循环,从而达到缓解患者下肢疼痛、麻木等临床症状,近期疗效令人满意,无血肿、血管破裂、远端血管栓塞等并发症发生。Objective To discuss urokinase,papaverine angiography in diabetic foot in clinical application.Methods Forty-seven cases of vascular doppler examination of lower extremity arterial stenosis prompted the merger and the performance of lower limb ischemia in diabetic patients,after the DSA angiography,nineteen cases who had tibial,peroneal artery,the distal or foot small artery stenosis or occlusion,used transcatheter bolus infusion method using 25~50Uten-thousand units of urokinase,papaverine 30-60mg.Results Fifteen cases of transcatheter infusion of urokinase,papaverine had marked improvement in the performance of lower limb ischemia,and through the comprehensive medical treatment,target vessel around the collateral vessels increased significantly in the total group of 100 percent of cases,stenosis lumen expansion over the previous was 68%,re-opening of vascular occlusion accounted for 36.8%.0~Ⅱ level surface of foot ulcer disease healed,Ⅲ~Ⅳ grade of foot ulcer surface drying,shrinking around the inflammation subsided.Conclusion Intra-arterial infusion of urokinase,papaverine can to some extent to improve lower limb blood circulation,so as to achieve remission in patients with lower extremity pain,numbness and other symptoms,has short-term efficacy,no hematoma,vascular rupture,distal embolism and other vascular complications occurred.

关 键 词：糖尿病足 尿激酶 罂粟碱 DSA血管造影 

分 类 号：R587.2[医药卫生—内分泌]