长球囊联合丹参注射液加压注射治疗糖尿病膝下血管病变  

Percutaneous Transluminal Angioplasty Combine with Salvia Injection Cura the Below Knee Vascular Lesion of Diabetic By Pressurize Injection

作　　者：路延平[1] 张健[2] 张孟增[1] 王瑞锋[1] 

机构地区：[1]河北省邢台市人民医院放射科,054031 [2]河北省邢台市人民医院内分泌科,054031

出　　处：《临床放射学杂志》2012年第10期1470-1473,共4页Journal of Clinical Radiology

摘　　要：目的观察长球囊血管腔内成形术(percutaneous transluminal angioplasty,PTA)联合丹参注射液,腔内加压注射治疗糖尿病膝下血管病变的疗效。方法 19例糖尿病患者共23条膝下动脉硬化闭塞肢体,首先采用长球囊开通狭窄、闭塞的血管,再联合丹参注射液腔内加压注射治疗。术后观察踝/肱指数、通畅率、溃疡愈合时间及临床症状的改善。结果 21条患肢得到成功治疗,技术成功率91.3%(21/23)。踝/肱指数(ankle brachial index,ABI)由术前的0.31±0.14上升为术后的0.71±0.18,与术前比较差异有统计学意义(P<0.05)。术后随访3～10个月,13条患肢(61.9%)间歇性跛行、患肢静息痛等临床症状基本消失,足背或胫后动脉搏动恢复;8条(38.1%)患肢明显缓解。6条肢体术前伴足趾溃疡者,术后创面均愈合;1条足趾坏疽肢体清创换药23天后行截趾术,术后切口愈合良好。术后1、3、6个月通畅率分别为95.2%、85.7%、61.9%。结论腔内加压注射丹参注射液作为长球囊PTA微创治疗糖尿病合并膝下血管病变的补充,可促进动脉侧支血管生成,改善血供,改善微循环,促进糖尿病足溃疡面愈合,近期疗效好、通畅率高,值得推广。Objective Review the curative effect of percutaneous transluminal angioplasty（PTA）combined with salvia injection to the below knee vascular lesion of diabetic.Methods Collect 19 diabetics with together 23 inferior genicular artery blunting.First,remove obstacles from angusty or obliterative blood vessel by percutaneous transluminal angioplasty（PTA）,then begin intracavitary pressurize injection used the salvia miltiorrhiza,and observe the ankle brachial index（ABI）,patency rate,the time of anabrosis healing and the amelioration of clinical symptom.Results The 21 affected limb of them were Curat successfully,the achievement ratio of technique was 91.3%（21/23）.ABI ascensus from 0.31±0.14 of preoperative to 0.71±0.18 of postoperative,the contrast had statistical significance（P〈0.05）.3-10 month follow up after operation,In 13 of them（61.9%） angina cruris and rest pain had delitescenced,and the arteriopalmus of dorsum of foot and arteria tibialis posterior had anastated.8 of them had a manifest anesis.6 of them which had a digiti anabrosis had been accreted.1 of them with toe amputation 23 days later after debride and change dressings healed well.The patency rate 1,3 and 6 month later after operation was 95.2%、85.7%、61.9%.Conclusion Intracavitary pressurize injection salvia miltiorrhiza as an addition to percutaneous transluminal angioplasty（PTA） of diabetes complic below knee vascular lesion,can enhance the collateral angiogenesis of artery,improve the blood supply,encourage the ulcer of foot accrete caused by diabetes.The effect is good in the near future and have a hypsopatency rate.It is deserve to vocate.

关 键 词：腔内血管成形 长球囊 膝下血管 丹参 加压注射 

分 类 号：R587.2[医药卫生—内分泌] R543[医药卫生—内科学]