股动脉注射治疗重症闭塞性下肢动脉硬化症42例

Curative Effect of 42 Cases with Severe Lower Limb Arteriosclerosis Obliterans via Intra Femoral Injection

目的:比较观测肢体股动脉穿刺行局部推注尿激酶和前列腺素E1的疗效是否优于静脉滴注給药,观察静脉输液针穿刺股动脉的局部并发症。方法:选择重症下肢动脉硬化闭塞症(PAD)86例患者,随机分为观察组和对照组。两组患者均口服西洛他唑、他汀类调脂药,并积极干预危险因素。对照组用微量泵静脉注射尿激酶和前列腺素E1稀释液,观察组用静脉穿刺针穿刺股动脉后缓慢推注给药,两组用药量和用药天数相同。结果:治疗第10天评估,两组病人观测肢体静息踝肱指数(ABI)值均明显高于治疗前(P<0.01);观察组患者的观测肢体静息ABI值高于对照组病人的观测肢体静息ABI值(P<0.05)。观察组和对照组观测肢体静息痛好转的显效率分别为35.71%、11.36%(P<0.01);总有效率分别为66.67%、45.45%(P<0.05)。无1例发生股动脉穿刺局部血肿和药物注入皮下。注射前列腺素E1时感下肢轻度发热。无注射时药物导致的肢体疼痛。结论:股动脉穿刺局部给药疗效优于静脉全身给药,而且穿刺局部并发症少。

Objective:To investigate whether the effect of intra femoral injection of urokinase and Prostaglandin E1for severe lower limb arteriosclerosis obliterans is better than intra intravenous drip,and as well as local complications of femoral artery puncture by intravenous infusion needle.Methods:86patients with severe lower limb arteriosclerosis obliterans were divided into the experimental group and the control group randomly;all the patients were taking cilostazol,statins,and accepting active intervention of risk factors.The patients in the control group were treated with urokinase and Prostaglandin E1via intravenous injection by micropump,and the ones in the experimental group were injected via femoral artery below the inguinal ligament.The dosage and time in both groups were the same.Results:After ten days,ankle-brachial indexes of both groups(ABI)were significantly higher than those before treatment(P<0.01),and ABI in the experimental group were higher than that in the control group(P<0.05).Effective rates of resting pain in the experimental group and the control group were respectively 35.71% and 11.36%(P<0.01),and the total efficiencies were 66.67%and 45.45%(P<0.05).None of the patients suffered from femoral artery puncture hematoma and subcutaneous drug injection.Conclusion:The effect of intra femoral injection is better than intravenous injection for the whole body with less local complications caused by artery puncture.