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背景:下肢闭塞性动脉硬化症常出现肢体发凉、麻木、疼痛、溃疡,重者发生肢体坏死,严重影响患者的下肢运动功能。目的:观察容量输液泵输注尿激酶对闭塞性动脉硬化性肢体缺血患者下肢疼痛及行走功能的改善作用。设计:随机分组,对照观察。单位:解放军沈阳军区总医院第二干部病房。对象:2000-01/2003-12解放军沈阳军区总医院第二干部病房诊断明确的77例下肢闭塞性动脉硬化患者,随机分为治疗组35例和对照组42例。方法:治疗组:经前臂静脉输注尿激酶50～70万U,每小时输注10万U,根据症状改善情况决定用药时间,5～8d一疗程。对照组:静脉滴注复方丹参30mL,1次/d,共15d。主要观察指标:两组治疗后下肢静息痛、麻木无力、间歇性跛行、行走距离的改善情况,以及不良反应。结果:按意向处理分析,两组77例均进入结果分析。①两组用药情况:治疗组每天应用容量泵输注尿激酶(60±12.1)万(50～70万)U,10万U/h,治疗(7±3.6)d(5～11d)。对照组均用复方丹参30mL×15d。②两组效果比较:治疗组静息痛消失率明显高于对照组[75%(9/35),30%(3/42),χ2=4.45,P<0.05],治疗组间歇性跛行改善率明显高于对照组[80.8%(17/35),39.1%(9/42),χ2=8.91,P<0.01],治疗组行走距离明显长于对照组[(120.2±23.5),(76.5±12.6)m,t=7.34,P<0.01]。③未发生出血病例。结论:应用容量泵输注尿激酶,可控制每小时用药量,改善了肢体的慢性缺血症状,75%的患者静息疼痛消失,80.8%的患者间歇性跛行改善,行走距离明显增加,显著提高了患者的下肢功能,且未出现出血现象。
Background: Occlusive arteriosclerosis of the lower extremities often appears cold limbs, numbness, pain, ulcers, severe cases of limb necrosis, severely affect the patient’s lower extremity motor function. Objective: To observe the effect of volume infusion pump infusion of urokinase on lower limb pain and walking function in patients with arteriosclerotic arterial occlusive disease. Design: randomized, controlled observation. Unit: People’s Liberation Army Shenyang Military Region General Hospital second cadre ward. PARTICIPANTS: A total of 77 patients with obstructive arteriosclerosis of the lower extremity diagnosed in the second cadre’s ward of PLA Shenyang Military Region General Hospital from January 2000 to December 2003 were randomly divided into treatment group (n = 35) and control group (n = 42). Methods: In the treatment group, urokinase was infused through the forearm vein at 500-700 U per hour, with 100,000 U per hour. According to the improvement of symptoms, medication time was determined and treated for 5-8 days. Control group: intravenous infusion of compound Salvia 30mL, 1 / d, a total of 15d. MAIN OUTCOME MEASURES: Resting pain, numbness, intermittent claudication, improvement of walking distance, and adverse reactions of the two groups after treatment. Results: According to intention analysis, 77 patients in both groups were involved in the result analysis. ① The two groups were treated: Urokinase (60 ± 12.1) million (500,000-700,000) U and 100,000 U / h were treated in the treatment group daily for 7 ± 3.6 days (5 ~ 11 days). The control group were treated with compound Danshen 30mL × 15d. ② The two groups were compared: the disappearance rate of resting pain in the treatment group was significantly higher than that of the control group [75% (9/35), 30% (3/42), χ2 = 4.45, P <0.05] The mean distance between two groups was significantly higher than that of the control group [80.8% (17/35), 39.1% (9/42), χ2 = 8.91, P <0.01] 12.6) m, t = 7.34, P <0.01]. ③ no bleeding cases. CONCLUSIONS: Urokinase infusion with a volumetric pump can control the dosage per hour and improve the symptoms of chronic ischemic limbs. Resting pain disappears in 75% of patients, intermittent claudication is improved in 80.8% patients, and the distance of walking is significantly increased Increased patient’s lower extremity function without bleeding.