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題名 | Prostaglandin E1 for Treatment of Chronic-Arterial Occlusive Disease in Stage III and IV=前列腺素E1用以治療第三級及第四級慢性週邊動脈阻塞性疾病 |
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作者 | 賴曉亭; 鄭國琪; 鄭伯智; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19910300、19910400 |
卷期 | 24:2 民80.03-04 |
頁次 | 頁584-589 |
分類號 | 416.263 |
語文 | eng |
關鍵詞 | 前列腺素E1; 第三級; 第四級; 慢性週邊動脈阻塞性疾病; |
中文摘要 | 95例患者經證實為第三級及第四級嚴重慢性週邊動脈阻塞性疾病無法接受血管外科重建術。患者分為兩組,接受PGE1治療組共有59例,男性59例,女性11位,平均年齡57±16.56歲,患者接受每日兩次40 μg溶於500 c.c.生理溶液中並經靜脈點滴兩小時。在對照組有36例,男性32位,女性4位,平均年齡為58±15.21歲,每日接受300 mg Aspirin及75 mg Persantine治療。 有24例第三級患者接受PGE1,治療後有18位(75%)進步到第一級,5例(20.8%)進步到第二級,僅有1例(4.2%)變化到第四級並須接受截肢術。控制組方面有14例屬第三級,接受治療後僅5例(35.7%)進步到第一級,2例(14.3%)進步到第二級,7例(50%)反而惡化到第四級。接受截肢的共2例(14.3%)。35例第四級患者在接受PGE1治療,發現有26例(76.3%)進步到第一級,1 例(2.6%)進步到第二級,僅2例(5.7%)進步到第三級,而6例(17.4%)仍然維持在第四級並無進步,3例(8.6%)須接受截肢術。在控制組有22例為第四級,僅1例(4.6%)進步到第一級,4例(18.2%)進步到第二級,6例(27.3%)進步到第三級,而11例(49.9%)仍維持在第四級毫無進步,而此11例須接受截肢術(49.9%)。而在潰瘍進展及肢體表淺皮膚溫度的變化在PGE1治療組方面皆優於控制組(P<0.05),具有統計學意義存在。 依我們臨床經驗顯示在PGE1治療組,患者可明顯改進息痛症狀,缺血性潰瘍亦可逐漸愈合並使皮膚表淺血流量增加,減少肢體截肢率。證寶PGE治療確實優於控制組的治療。我們建議PGE1可治療無法接受血管重建術矯正的嚴重週邊動脈阻塞性患者。 |
英文摘要 | 95 patients with a advanced chronic arterial occlusive disease documented in the fontaine stage III and IV were unable to be performed the vascular reconstruction. In PGE1 group, 59 patients (48 male and 11 female), mean age was 57±16.56 years old, were given a usual dose of 40 μg of PGE1 in 500 ml of i.v. fluid and delivered by i.v. drip of infusion over 2 hours twice per day for two weeks. In the control group, the 36 patients (32 male and 4 female), mean age was 58±15.21 years old, were received the standard therapy with 300 mg aspirin and 75 mg persantin for over 2 weeks. 18 patients out of 24 patients (75%) in the stage III receiving PGE1 treatment improved to stage I. One patient (4.2%) needed an amputation. Of 14 patients in the stage III in the control group, only 5 patients (35.7%) improved to the stage I. An amputation was required to 2 patients (14.3%). 26 patients out of 35 patients (76.3%) in stage IV receiving PGE1 treatment improved to the stage I. Three patients (8.6%) needed the amputation. Twenty-two patients in the stage IV receiving the control group therapy. Only one patient (4.6%) improved to the stage I and the amputation was required to 11 patients (49.9%). The amputation was necessary to 4 patients (6.7%) receiving PGE1 treatment and 13 patients (36.1%) in the control group therapy. Ulcerhealing and ulcer improvement and a rise in the skin temperature were more noted in PGE1 group than the control group. The differency is statistically significant. (P<0.05) The final assessment was that the results of PGE1 treatment were better than the control group therapy. We suggest that PGE1 is an advisable vesodilator for the treatment of severe peripheral arterial occlusive disease that is not amenable to the vascular recontruction. |
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