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【摘要】 目的 观察空气波压力治疗仪对糖尿病下肢动脉血管病变的影响。方法 选取2006年10月—2009年5月住院的2型糖尿病下肢动脉血管病变患者30例,采用四阶段压力治疗仪治疗,观察治疗腘动脉、胫前动脉、胫后动脉和足背动脉的内径和血流量。结果 糖尿病下肢动脉血管病变经压力治疗仪治疗后,腘动脉、胫前动脉、胫后动脉和足背动脉内径均增加, 但差异无显著性。腘动脉、胫前动脉、胫后动脉和足背动脉血流量在治疗后均增加, 胫后动脉和足背动脉血流在治疗前后差异有显著性(P<0.05及P<0.01)。经空气波气压治疗后, 30例受试者均感觉行走有力,有间歇性跛行的12例患者最大耐受行走距离明显增加。结论 空气波气压治疗对糖尿病下肢动脉血管病变具有肯定的治疗作用。其可以扩张腘动脉、胫前动脉、胫后动脉和足背动脉的内径,增加其血流量,但是其最主要的靶向部位在胫后动脉和足背动脉,扩张这些较小的肢端动脉,可有效改善症状。
【关键词】 空气波压力治疗;糖尿病;下肢血管
[Abstract] Objective To evaluate the effects of air pressure massage by digital four-tiered rippling system on the lower limb blood vessel in diabetic patients. Methods The study was performed in 30 patients with diabetes related lower limb vascular disease. Before and after air pressure massage treatment for 28 days, vascular diameter and blood flow velocity of poplitea artery, anterior tibialis artery, posterior tibialis artery and dorsal pedal artery were measured by Doppler ultrasonography examination.Results After the treatment with air pressure massage, the vascular diameters of poplitea artery, anterior tibialis artery, posterior tibialis artery and dorsal pedal artery were dilated; however, there were no significantly statistical differences. After the treatment with air pressure massage treatment, blood flow velocity of femoral artery, poplitea artery, anterior tibialis artery, posterior tibialis artery and dorsal pedal artery were increased, and there were significant differences in posterior tibial artery and dorsal pedal artery. After the treatment with air pressure massage, all the patients feel well. Maximal walking distance of 12 patients with intermittent claudication were increased.Conclusion Air pressure massage treatment causes a significant improvement of diabetes related lower limb vascular disease. Furthermore, the results demonstrated the major effects on posterior tibialis artery and dorsal pedal artery. Air pressure massage treatment can dilate the smaller artery, which is important and helpful for patients to improve symptoms and signs.
[Key words] air pressure massage ; diabetes; lower limb blood vessel
随着我国人们生活水平的不断提高,人群饮食不合理现象逐渐显现,动脉粥样硬化症的发病率也随之增加,这种现象在糖尿病患者中尤其显著。下肢血管病变是2型糖尿病常见慢性并发症之一。2型糖尿病(T2-DM)确诊时, 8%~10%的患者已有明显的下肢动脉硬化性病变[1],严重影响患者的生活质量,治疗费用巨大。改善糖尿病患者下肢血液供应,从而有效治疗糖尿病足、降低截肢率一直是糖尿病领域研究的重点之一。本文主要探讨四阶段空气波压力治疗对糖尿病下肢动脉血管病变的影响。
1 资料与方法
1.1 资料 选取本院内科2006年10月—2009年5月住院的2型糖尿病患者30例,其糖尿病诊断符合1999年WHO诊断标准。其中男18例,女12例;年龄35~70岁,平均( 54.7 ±10.2)岁,糖尿病病程2个月~14年,平均(5.9 ±4.1)年,糖尿病下肢动脉血管病变病史0~8年。所有的患者均行双下肢动脉多普勒检查,证实存在双下肢动脉血管病变。
1.1.1 诊断标准 血管内膜粗糙、增厚、血栓形成或动脉粥样硬化斑块、内径变细、血流量减少。
1.1.2 排除标准 丹毒、肺水肿、急性静脉血栓、