对股动脉灌注丹参注射液治疗缺血性糖尿病足的临床疗效评估

发布时间：2018-06-10 20:40

本文选题：糖尿病足 + 缺血性糖尿病足　；参考：《华北理工大学》2017年硕士论文

【摘要】：目的通过对股动脉灌注丹参注射液治疗缺血性糖尿病足的临床疗效评估,为此疗法治疗缺血性糖尿病足提供临床数据。方法以我院2015年6月-2017年2月入住的缺血性糖尿病足患者为研究对象,选取其中90例,采用随机抽号方法:列出流水号为01～90,符合纳入标准及排除标准的患者随机抽取一个号码,按列出的流水号01～90所对应的治疗分配.即对照组(1-30)治疗组A (31-60)治疗组B (61-90)。对照组:静脉滴注的方式注射丹参注射液;治疗A组:股动脉灌注丹参注射液;治疗B组:股动脉灌注前列地尔注射液,隔日一次,15次为一疗程。记录患者治疗前的创面大小、血脂、血常规、血液流变学指标:全血黏度高切和低切、红细胞变形指数、血浆黏度、红细胞聚集指数、血沉;血生化指标:FIB、FBG、CRP、Hcy、ALT、AST、CRE;的检验结果,治疗一疗程后再次记录上述指标检验结果,观察其前后变化情况,统计分析检验数据得出结论。结果1)三组经治疗后,与治疗前相比,三组在WBC、HCT、PLT、PCT、TG五项指标中有所下降(P0.05),治疗后,治疗A组WBC为5.12×109/L、TG为0.83mmol/L,对照组WBC为8.87×109/L、TG为1.75mmol/L,通过统计学分析差异具有统计学意义(P0.05) ; 2)经治疗后三组患者血液流变学参数得到了改善,与治疗前相比,对照组血浆黏度有所下降(P0.05),治疗A组、B组全血黏度、血浆黏度、红细胞聚集指数都有所下降(P0.05),红细胞变形指数升高(P0.05),治疗后,治疗A组全血黏度低切为8.14 (200/s) mPa.s、红细胞变形指数为0.72,对照组全血黏度低切为9.83 (200/s) mPa.s、红细胞变形指数为0.61,通过统计学分析差异具有统计学意义(P0.05) ; 3)三组治疗后,与治疗前相比,血清FIB和CRP含量表现出下降结果,差异具有统计学意义(P0.05);在治疗后,治疗A组FIB为3.25/L,对照组FIB为2.31g/L,差异具有统计学意义(P0.05),治疗后,治疗A组和治疗B组CRP分别为29.38mg/ml、32.02mg/ml,对照组CRP为35.17mg/ml,通过统计学分析差异具有统计学意义(P0.05) ; 4)与治疗前相比,治疗后三组患者创面明显好转,差异具有统计学意义(P0.05),治疗后,A组长径为6.64mm,短径为4.00mm,对照组长径为9.54mm,短径为6.21mm通过统计学分析差异具有统计学意义(P0.05) ; 5)三组治疗后临床有效率:对照组为56.67%,治疗B组为70.00%,治疗A组为83.33%,通过统计学分析差异具有统计学意义(P0.05);基于不良反应角度,A组与B组、对照组在ALT、AST、CRE的检验结果差异不显著,差异不具有统计学意义(P0.05)。结论股动脉灌注丹参注射液具有抗凝、抗炎作用并能显著改善患者血液流变学参数水平;与静脉滴注丹参注射液和股动脉灌注前列地尔注射液相比,股动脉灌注丹参注射液具有更为显著的疗效;股动脉灌注药物的治疗在安全性方面无不良反应。
[Abstract]:Objective to evaluate the clinical effect of Salvia miltiorrhiza injection on ischemic diabetic foot and provide clinical data for treating ischemic diabetic foot. Methods 90 patients with ischemic diabetic foot admitted in our hospital from June 2015 to February 2017 were selected and randomly selected. According to the list of water number 01U 90 corresponding to the treatment distribution. Control group 1-30) treatment group A 1-60) treatment group B 1-90. Control group: Danshen injection by intravenous drip; treatment group A: femoral artery infusion of Salvia miltiorrhiza injection; treatment group B: femoral artery infusion of alprostadil injection, 15 times every other day as a course of treatment. The wound size, blood lipid, blood routine and hemorheology were recorded before treatment: whole blood viscosity, high and low shear rate, erythrocyte deformability index, plasma viscosity, erythrocyte aggregation index, erythrocyte sedimentation rate; After a course of treatment, the results of the above indexes were recorded again, the changes before and after treatment were observed, and the statistical analysis data were analyzed to draw a conclusion. Results 1) after treatment, compared with before treatment, the three groups had a decrease in the five indexes of WBC+ HCT, PLT, PCT, TG, and after the treatment, there was no significant difference between the three groups and the control group (P < 0. 05). In group A, WBC was 5.12 脳 10 9 / L, TG was 0.83mmol / L, and in control group, WBC was 8.87 脳 10 9 / L, TG was 1.75 mmol / L, the difference was statistically significant (P0.05); (2) after treatment, the hemorheological parameters of the three groups were improved, compared with those before treatment. The blood viscosity, plasma viscosity, erythrocyte aggregation index, erythrocyte deformability index and erythrocyte deformability index were decreased in group A and B, respectively. In treatment group A, the whole blood viscosity was 8.14 / 200 / s) MPA. S, erythrocyte deformability index was 0.72, in control group, the whole blood viscosity was 9.83 / 200 / s) MPA. S, erythrocyte deformability index was 0.61.The difference was statistically significant (P0.05); 3) after treatment, compared with before treatment, After treatment, the FIB of group A was 3.25 / L, and the FIB of control group was 2.31 g / L, the difference was statistically significant (P 0.05). CRP in group A and group B were 29.38 mg / ml and 35.17 mg / ml, respectively, and those in control group were 35.17 mg / ml. The difference was statistically significant (P 0.05). After treatment, the length diameter was 6.64 mm, the short diameter was 4.00 mm, the control group was 9.54 mm, and the short diameter was 6.21mm. The difference was statistically significant (P 0.05); 5) the clinical effective rate of the three groups after treatment was 56.67 mm, and that of the control group was 56.67 mm. The difference was statistically significant (P 0.05) between group A and group B, based on adverse reaction angle, there was no significant difference between group A and group B. There was no significant difference in the results of CRE test between the control group and the control group, but the difference was not statistically significant (P 0.05). Conclusion femoral artery infusion of Salvia miltiorrhiza injection has anticoagulant and anti-inflammatory effects and can significantly improve the level of hemorheological parameters, compared with intravenous infusion of Salvia miltiorrhiza injection and femoral artery perfusion of alprostadil injection. Salvia miltiorrhiza injection was more effective in femoral artery perfusion, and no adverse reaction was found in the treatment of femoral artery infusion drugs.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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