本文選題：糖尿病足 + 缺血性糖尿病足　； 參考：《華北理工大學》2017年碩士論文

【摘要】：目的通過對股動脈灌注丹參注射液治療缺血性糖尿病足的臨床療效評估,為此療法治療缺血性糖尿病足提供臨床數(shù)據(jù)。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為研究對象,選取其中90例,采用隨機抽號方法:列出流水號為01～90,符合納入標準及排除標準的患者隨機抽取一個號碼,按列出的流水號01～90所對應(yīng)的治療分配.即對照組(1-30)治療組A (31-60)治療組B (61-90)。對照組:靜脈滴注的方式注射丹參注射液;治療A組:股動脈灌注丹參注射液;治療B組:股動脈灌注前列地爾注射液,隔日一次,15次為一療程。記錄患者治療前的創(chuàng)面大小、血脂、血常規(guī)、血液流變學指標:全血黏度高切和低切、紅細胞變形指數(shù)、血漿黏度、紅細胞聚集指數(shù)、血沉;血生化指標:FIB、FBG、CRP、Hcy、ALT、AST、CRE;的檢驗結(jié)果,治療一療程后再次記錄上述指標檢驗結(jié)果,觀察其前后變化情況,統(tǒng)計分析檢驗數(shù)據(jù)得出結(jié)論。結(jié)果1)三組經(jīng)治療后,與治療前相比,三組在WBC、HCT、PLT、PCT、TG五項指標中有所下降(P0.05),治療后,治療A組WBC為5.12×109/L、TG為0.83mmol/L,對照組WBC為8.87×109/L、TG為1.75mmol/L,通過統(tǒng)計學分析差異具有統(tǒng)計學意義(P0.05) ; 2)經(jīng)治療后三組患者血液流變學參數(shù)得到了改善,與治療前相比,對照組血漿黏度有所下降(P0.05),治療A組、B組全血黏度、血漿黏度、紅細胞聚集指數(shù)都有所下降(P0.05),紅細胞變形指數(shù)升高(P0.05),治療后,治療A組全血黏度低切為8.14 (200/s) mPa.s、紅細胞變形指數(shù)為0.72,對照組全血黏度低切為9.83 (200/s) mPa.s、紅細胞變形指數(shù)為0.61,通過統(tǒng)計學分析差異具有統(tǒng)計學意義(P0.05) ; 3)三組治療后,與治療前相比,血清FIB和CRP含量表現(xiàn)出下降結(jié)果,差異具有統(tǒng)計學意義(P0.05);在治療后,治療A組FIB為3.25/L,對照組FIB為2.31g/L,差異具有統(tǒng)計學意義(P0.05),治療后,治療A組和治療B組CRP分別為29.38mg/ml、32.02mg/ml,對照組CRP為35.17mg/ml,通過統(tǒng)計學分析差異具有統(tǒng)計學意義(P0.05) ; 4)與治療前相比,治療后三組患者創(chuàng)面明顯好轉(zhuǎn),差異具有統(tǒng)計學意義(P0.05),治療后,A組長徑為6.64mm,短徑為4.00mm,對照組長徑為9.54mm,短徑為6.21mm通過統(tǒng)計學分析差異具有統(tǒng)計學意義(P0.05) ; 5)三組治療后臨床有效率:對照組為56.67%,治療B組為70.00%,治療A組為83.33%,通過統(tǒng)計學分析差異具有統(tǒng)計學意義(P0.05);基于不良反應(yīng)角度,A組與B組、對照組在ALT、AST、CRE的檢驗結(jié)果差異不顯著,差異不具有統(tǒng)計學意義(P0.05)。結(jié)論股動脈灌注丹參注射液具有抗凝、抗炎作用并能顯著改善患者血液流變學參數(shù)水平;與靜脈滴注丹參注射液和股動脈灌注前列地爾注射液相比,股動脈灌注丹參注射液具有更為顯著的療效;股動脈灌注藥物的治療在安全性方面無不良反應(yīng)。
[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.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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本文編號：2004543