目的 探讨运用自体外周血干细胞移植疗下肢动脉缺血性疾病,并对其疗效进行临床观察.方法 本研究共入组58例下肢动脉缺血性疾病患者,均进行自体外周血进行干细胞移植治疗.对患者的疼痛感、冷感、间歇跛行、踝肱指数(ABI)、侧支血管生成数量等指标进行治疗前后比较,从而评估自体外周血干细胞移植疗下肢动脉缺血性疾病治疗效果.结果 患者治疗后在疼痛感、冷感、间歇跛行3个方面较治疗前明显降低,差异具有显著性(P＜0.05),ABI评分与侧支血管生成数评分方面,差异具有显著性(P＜0.05).自体外周血进行干细胞移植的有效率是84.4%.结论 自体外周血干细胞移植是治疗下肢动脉缺血性疾病的安全而有效方法.

目的 观察联合经皮腔内血管成形术(PTA)及自体外周血干细胞移植(ABSCT)治疗下肢动脉缺血性疾病可行性和近期效果.方法 研究共入组48例下肢动脉缺血性疾病患者,依自愿原则分组,仅采用PTA治疗的19例患者为PTA组,单纯ABSCT组10例,PTA与ABSCT联合治疗的19例患者为联合治疗组.常规治疗方案3组相同,对3组患者的疼痛感、冷感、间歇跛行、踝肱指数(ABI)、侧支血管生成数量等方面的指标进行比较,从而判断3组患者的疗效差异.结果 在疼痛感、冷感、间歇跛行3方面3组患者均明显降低,差异有统计学意义(P＜0.05),ABI评分与侧支血管生成数评分方面,3组均升高,差异有统计学意义(P＜0.05).与PTA及ABSCT组比较,联合治疗组在疼痛感、冷感、间歇跛行方面、ABI评分与侧支血管生成数评分改善更为明显(P＜0.05).联合治疗组的有效率是89.5％,PTA组的有效率是78.9％,ABSCT组的有效率是60.0％,联合治疗组效果显著优于PTA组和ABSCT组(P＜0.05).结论 PTA联合ABSCT治疗下肢动脉缺血性疾病安全、有效,疗效优于单纯PTA术及单纯ABSCT移植治疗.

Objective:To investigate the autologous peripheral blood stem cell transplantation ( ABSCT) combined with inter-ventional therapy in treatment of chronic lower limb ischemia. Methods:38 patients with chronic lower limb ischemia were divided into 2 groups. 19 patients treated with ABSCT combined with interventional therapy were used as combined treatment group,and the other 19 patients treated with autologous peripheral blood stem cell transplantation and interventional as single interventional therapy group. The patients in two groups receieved conventional therapy. The limb pain, cold feeling, intermittent claudication, ankle brachial index (ABI) and the number of collateral vessel formation of the patients in two groups were observed before and after treatment,and the cur-ative effects in two groups were compared. Results:Compared with before treatment,the limb pain scores,cold feeling scores and inter-mittent claudication scores of the patients in two groups after treatment were significantly decreased,the differences were statistically sig-nificant (P＜0. 05),and the ABI and the number of collateral vessel formation were increased,and the difference was statistically sig-nificant (P＜0. 05). Compared with the intervention group,the limb pain,cold feeling,intermittent claudication,ABI and the number of collateral vessel formation of the patients in the combined treatment group were more significant (P＜0. 05). The total effective rate of the two groups were 89. 5% and 78. 9% ,respectively,the total effective rate in combinaed treatment group was higher than that in sin-gle interventional therapy group (P＜0. 05). Conclusion:ABSCT combined with interventional therapy is a safe and effective method for the treatment of chronic lower limb ischemia.

目的:将腹腔镜下肠粘连松解术和传统开腹手术治疗粘连性肠梗阻的疗效进行比较,探讨腹腔镜下肠粘连松解术用于粘连性肠梗阻的可行性和优越性。方法:选择实施肠粘连梗阻手术患者51例,其中25例行腹腔镜下肠粘连松解术,另26例采用传统开腹手术治疗,比较两组患者的治疗效果。结果:腹腔镜组的手术用时、术后下床活动时间、肠功能恢复时间、术后腹腔引流、伤口感染、住院时间等方面明显优于开腹组,两组的比较差异均有统计学意义。结论:腹腔镜下肠粘连松解术具有创伤小、术后恢复快、发症少等优点,在严格掌握和遵循手术指证的前提下,为解决粘连性肠梗阻需反复手术的临床难题提供了一个新的方法和思路。