前列地尔联合下肢血管介入治疗糖尿病足的临床效果

Clinical Effects of Alprostadil Combined with Lower Extremity Vascular Intervention for Diabetic Foot

目的探讨前列地尔联合介入治疗糖尿病组的治疗效果。方法选取2020年3月—2022年6月云南省德宏州人民医院收治的80例糖尿病足患者为研究对象。按照随机数表法分为两组,各40例。对照组均在局部麻醉下实施下肢血管介入治疗,观察组联合应用前列地尔。比较连续治疗14 d后两组肉芽组织再生情况,组织纤溶酶原激活物水平及足部超声指标变化,统计下肢溃疡病灶愈合指标及不良反应。结果治疗14 d后,观察组肉芽组织覆盖率为(68.92±13.51)%,大于对照组的(48.92±8.63)%,肉芽组织厚度为(3.15±0.25)mm,大于对照组的(1.38±0.12)mm,差异有统计学意义(P<0.05)。治疗14 d后,观察组组织纤溶酶原激活物水平高于治疗前,且高于对照组,足背动脉内径及血流速度水平大于治疗前,且高于对照组,差异有统计学意义(P<0.05)。疼痛缓解时间为(4.31±1.11)d,溃疡病灶结痂时间为(12.0±3.27)d,溃疡病灶愈合时间为(22.7±4.25)d,均优于对照组,差异有统计学意义(P<0.05)。严重疼痛、感染、创面变白及创周皮疹的总发生率低于对照组,差异有统计学意义(P<0.05)。结论针对糖尿病足患者应用前列地尔联合血管介入治疗,可有效地促进足部溃疡愈合,调节机体纤溶状态,扩张下肢血管,改善患者临床症状,减少治疗不良反应。

Objective To investigate the therapeutic effect of alprostadil combined with interventional treatment for diabetic group.Methods Eighty cases of diabetic foot patients admitted to Dehongzhou People's Hospital in Yunnan Province from March 2020 to June 2022 were selected as the study subjects.According to the random number table method,they were divided into two groups of 40 cases each.In the control group,all lower limb vascular interventions were performed under local anesthesia,and in the observation group,alprostadil was applied in combination.The regeneration of granulation tissue,the level of tissue fibrinogen activator and ultrasound indexes of the foot were compared between the two groups after 14 days of continuous treatment,and the healing indexes of lower limb ulcer lesions and adverse reactions were counted.Results After 14 days of treatment,the granulation tissue coverage rate of the observation group was(68.92±13.51)%,which was greater than that of the control group(48.92±8.63)%,and the thickness of granulation tissue was(3.15±0.25)mm,which was greater than that of the control group(1.38±0.12)mm,the difference was statistically significant(P<0.05).After 14 days of treatmen,the tissue fibrinogen activator level in the observation group was higher than before treatment,and higher than that in the control group,the dorsalis pedis artery internal diameter and blood flow velocity levels were greater than before treatment and greater than that in the control group,the difference was statistically significant(P<0.05).In the observation group,the time to pain relief was(4.31±1.11)d,the time to crusting of the ulcerated lesion was(12.0±3.27)d,and the time to healing of the ulcerated lesion was(22.7±4.25)d,all better than those in the control group,the difference was statistically significant(P<0.05).And the overall incidence of severe pain,infection,whitening of the wound surface and peri-wound rash werelower than those in the control group,the difference was statistically significant(P<0.05).Conclusion Alprostadil combined with vascular intervention for diabetic foot patients can effectively promote the healing of foot ulcers,regulate the fibrinolytic state of the body,dilate the lower limb blood vessels,improve the clinical symptoms of patients,and reduce the adverse effects of treatment.