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以Buereger病(TAO)为代表的四肢动脉闭塞性疾病,尤其在血行再建术及交感神经切除术后或无手术适应症的患者,痛苦很大,治疗困难。作者用胍乙啶作静脉逆行性交感神经阻滞术治疗安静时疼痛的8例TAO患者,其中4例为一般药物治疗无反应并有指趾顽固性溃疡者。使患肢上举1分钟,加压至200mmHg后,静脉注射胍乙啶,10分钟药物扩散,慢慢解除加压。给药剂量:胍乙啶20mg、生理盐水40ml加少量肝素,一日1次,10次为一疗程,上肢用量减半。
Arterial occlusive disease represented by Buereger’s disease (TAO), especially in patients after revascularization and sympathectomy or without surgical indications, is very painful and difficult to treat. The authors used guanethidine for venous retrograde sympathectomy for the treatment of silent pain in 8 patients with TAO, 4 of whom were refractory to general medical therapy and had refractory toe stings. The limbs were held for 1 minute, pressurized to 200mmHg, intravenous guanethidine, 10-minute drug diffusion, and slowly relieve the pressure. Dosing: guanethidine 20mg, 40ml saline plus a small amount of heparin, 1 times a day, 10 times for a course of treatment, halved the amount of upper limbs.