山莨菪碱联合尿激酶股动脉注射治疗糖尿病下肢血管病变的效果观察及护理体会

The Effect Observation and Nursing Experience of Anisodamine and Urokinase through Intra-femoral Arterial Infusion on Lower Extremity Vascular Disease in Diabetes

目的探讨山莨菪碱与尿激酶股动脉注射治疗糖尿病下肢血管病变的效果,总结护理体会。方法选择2008年2月～2009年2月经血管多普勒超声检查证实下肢血管病变的2型糖尿病住院患者120例,随机分为治疗组与对照组。两组均予降糖及前列地尔常规治疗。治疗组在此基础上予山莨菪碱15mg或尿激酶10万单位加0.9%氯化钠10ml交替进行股动脉注射,每日1次,共10d。观察两组治疗前、后下肢血流及临床症状的改善情况。结果治疗组临床症状明显改善,总有效率91.7%,对照组总有效率83.3%,两组比较差异有统计学意义(P<0.05)。治疗后复查血管多普勒超声,治疗组受试侧股动脉、腘动脉、足背动脉血管内径及血流量与治疗前比较差异有统计学意义(P<0.05),与对照组比较差异有统计学意义(P<0.05)。治疗组30例出现不良反应,其中轻微口干20例,视物模糊5例,心率加快3例,排尿困难2例,均未影响治疗,予对症处理后缓解或自行缓解。结论山莨菪碱联合尿激酶股动脉注射治疗糖尿病下肢血管病变安全有效,加强护理有助于减少并发症的发生。

Objective To discuss the effect of anisodamine and urokinase through intra-femoral arterial infusion on lower extremity vascular disease in diabetes,and summarize the nursing experience.Methods 120 inpatients with type 2 diabetes admitted during February 2008~February 2009 were divided into treatment group and control group The patients were confirmed to suffer from lower extremity vascular disease by Doppler ultrasonography.Both groups were given conventional therapy of alprostadil and glucose reduction.The treatment group received intra-femoral arterial infusion with 15 mg anisodamine or urokinase 100 000 units plus 10 ml 0.9% sodium chloride alternately per day,for a total of 10 d.Lower extremity blood flow and improvement of clinical symptoms before and after treatment were observed.Results The clinical symptoms of treatment group improved significantly with an effective rate of 91.7%,but the effective rate was 83.3% in control group,with statistically significant difference（P0.05）.The vessel diameter and blood flow of subjected femoral artery,popliteal artery and dorsalis pedis artery in treatment group showed statistically significant difference when compared with that before treatment（P0.05）,and there was significant difference between the two groups（P0.05）.30 patients in treatment group had adverse reactions,among whom 20 had mild dry mouth,5 had blurred vision,3 had heart rate fasting,2 had dysuria.They had no effect on treatment,but all the patients＇ symptoms were alleviated after they received symptomatic treatment or mitigated spontaneously.Conclusion Anisodamine and urokinase of intra-femoral arterial infusion is effective and safe in treatment of lower extremity vascular disease in diabetic patients and strengthened nursing is contributed to reducing complication.