经皮腔内血管成形术联合银杏叶提取物治疗糖尿病下肢动脉闭塞症疗效观察

吴昊 蒋劲松 卢惟钦 杨光唯 来集富 卢凯平 虞聪

[摘要] 目的 探讨经皮腔内血管成形术与银杏叶提取物联合治疗糖尿病下肢动脉闭塞症的疗效。 方法 选择2013年5月～2015年6月我院收治的糖尿病下肢动脉闭塞症患者52例（59条患肢）为研究对象，根据治疗方法分为观察组（28例）与对照组（24例）；观察组给予经皮腔内血管成形术治疗，同时在术后给予银杏叶提取物治疗，对照组给予常规保守治疗，观察两组患者临床疗效及相关指标积分等。 结果 观察组32条患肢均顺利置入导丝通过闭塞段血管段，10条（31.3%）患肢同时置入支架治疗。观察组治疗总有效率显著高于对照组（P<0.05）。观察组术后3个月ABI、足背动脉内经、血流峰速、血流量、疼痛积分、行走距离积分、MNCV、SNCV均显著改善，且优于对照组（P<0.01）。观察组治疗后12个月再狭窄患肢12.50%，显著低于对照组的40.74%，差异有统计学意义（P<0.05）。 结论 对糖尿病下肢动脉闭塞症患者采用经皮腔内血管成形术联合银杏叶提取物治疗，疗效显著，安全可靠，可改善血液灌注，同时有效发挥中药优势，达到标本兼治的效果。

[关键词] 糖尿病；下肢动脉闭塞症；血管成形术；银杏叶提取物

[中图分类号] R587.2 [文献标识码] B [文章编号] 1673-9701（2015）34-0096-04

Efficacy of percutaneous endovascular angioplasty combined with Ginkgo biloba extract in treatment of diabetic lower extremity arterial occlusive disease

WU Hao JIANG Jinsong LU Weiqin YANG Guangwei LAI Jifu LU Kaiping YU Cong

Department of Vascular Surgery， Zhejiang Provincial People's Hospital， Hangzhou 310014， China

[Abstract] Objective To provide evidence for the clinical treatment of diabetic lower extremity arterial occlusive disease with the combination of percutaneous endovascular angioplasty and ginkgo leaf extract treatment in the treatment of diabetic lower extremity arterial occlusive disease. Methods Selected 52 cases （59 patients with limb） of diabetic lower extremity arterial occlusive disease in our hospital were selected as the research object from May 2013 to June 2015. According to the treatment method， the observation group （28 cases） and the control group （24 cases）. The observation group was treated by percutaneous endovascular angioplasty， while the control group was treated with conventional conservative treatment， and the clinical efficacy of the two groups were observed. Results In the observation group， 32 patients were successfully placed in the vascular segment of the guide wire， and 10 （31.3%） patients were treated with stent implantation at the same time. The total effective rate of the observation group was significantly higher than that of the control group （P<0.05）. In the observation group， 3 months after operation， the ABI， the foot dorsal artery， blood flow velocity， blood flow， pain score， walking distance， MNCV， SNCV scores were significantly improved， and better than the control group（P<0.01）. In the observation group， 12 months after treatment， 12.50% of the patients were significantly lower than those of the control group （40.74%）， the difference was statistically significant （P<0.05）. Conclusion The treatment of diabetic lower extremity arterial occlusive disease by percutaneous endovascular angioplasty combined with Ginkgo biloba extract is effective， safe and reliable， can improve blood perfusion， and can effectively exert the advantages of Chinese medicine， to achieve the effect of the treatment of the specimen and the treatment.

[Key words] Diabetes； Lower extremity arterial occlusive disease； Angioplasty； Ginkgo biloba extract

糖尿病晚期患者往往容易发生糖尿病下肢动脉闭塞症，该并发症是患者致残的主要因素。糖尿病晚期患者下肢动脉内膜出现粥样斑块、中膜发生钙化或者变性，腔内继发形成血栓，进而造成管腔的狭窄，甚至是闭塞[1]。在糖尿病下肢动脉闭塞症的临床治疗中，经皮腔内血管成形术（PTA）是一种较为有效的方法，通过加压气囊对粥样斑块实施压迫，使其受压破裂，从而达到扩张动脉管腔的目的。近年来，有临床研究发现，银杏叶提取物用于治疗糖尿病下肢血管病变有较好的疗效，可明显改善血流，扩张血管，延缓病情的发展[2]。我院在对糖尿病下肢动脉闭塞症的治疗中采用经皮腔内血管成形术联合银杏叶提取物治疗方案，为进一步探讨PTA联合银杏叶提取物治疗糖尿病下肢血管病变的临床疗效与应用价值进行此次研究，现报道如下。……