中国全科医学2013，Vol.16Issue(18)：2152-2156,5.DOI:10.3969/j.issn.1007-9572.2013.06.105
自体骨髓干细胞移植治疗下肢缺血性疾病的疗效观察
Curative Effect of Autologous Bone Marrow Stem Cell Transplantation in the Treatment of Ischemic Disease of Lower Limb
任超 1刘小云 2耿德勤 1葛巍 1张伟伟 1李金梅 1万美容 2徐铁3
作者信息
- 1. 221002江苏省徐州市,徐州医学院附属医院神经内科
- 2. 221002江苏省徐州市,徐州医学院附属医院中心实验室
- 3. 221002江苏省徐州市,徐州医学院附属医院急诊科
- 折叠
摘要
Abstract
Objective To observe the clinical efficacy and side effects on the patients with lower limb ischemic disease who been treated by autologous bone marrow stem cell transplantation and to explore the advantages of the model of team - working by doctors and nurses in the treatment process. Methods One T2DM patient admitted to our hospital on February 10, 2010 and June 1 , 2010 with left lower extremity diabetic foot ( gangrene type ) and with left lower peripheral arterial occlusive disease caused by extremity atherosclerosis and thrombosis respectively were both treated by autologous bone marrow stem cells transplantation for three times, and during the process the model of team - working by doctors and nurses was adopted. All the patients were followed up for two years to observe curative efficacy and adverse effect. Results For the first patient, before treatment, there were necrosis and ulceration in the fourth digit of foot and purulent secretion in the joint of toe root and upper surface of feet. The patient was painful and cannot walk. Color doppler ultrasound of double lower limbs showed atherosclerosis and occlusive disease in dorsal arteries of double feet and atherosclerosis in common femoral artery, deep femoral artery, superficial femoral artery and popliteal artery of both lower limbs. CTA showed sparse suppliers of blood in the left foot. After one - month treatment, the pain in the foot was alleviated. After three - month treatment, skin temperature increased and the beat of dorsal arteries could be felt. After six - month treatment, the ulceration began to heal, skin temperature continued to increase and its color turned into pink. After one - year treatment, the ulceration continued to heal. After two - year treatment, CTA showed better blood flow of blood suppliers and only a small area of ulceration left unhealed. For the second patient, before treatment, left lower limb was sore and weak, and limp occurred intermittently and it aggravated when standing upright and walking and partly alleviated when resting. Physical examination showed cyanosis and asperity in the fourth and fifth digit of foot and weak beat of dorsal arteries as well as reduced skin temperature. CTA of both lower limbs showed segmental lumen occlusion in the far end of left femoral artery, left popliteal artery, left anterior tibial artery and left posterior tibial artery as well as shallow development of left leg artery. After one - month treatment, the pain when standing up alleviated, the beat of dorsal arteries was enhanced and the skin temperature was also increased. After three - month treatment, the walking distance was prolonged and the frequency of pain was reduced. After six - month treatment, the color of the fourth and fifth digit of foot turned into pink. After one - year treatment, the fourth and fifth digit of foot was no longer rough but smooth. After two - year treatment, CTA showed more blood suppliers. After three transplantations, no local or body adverse effect was found. Conclusion Autologous bone marrow stem cells transplantation is feasible, convenient, safe and effective method in the treatment of lower limb ischemia disease. The model of team - working by doctors and nurses is conducive to the implementation of transplantation.关键词
骨髓/干细胞移植/下肢缺血性疾病Key words
Bone marrow/ Stem cell transplantation/ Lower limb ischemia disease分类
医药卫生引用本文复制引用
任超,刘小云,耿德勤,葛巍,张伟伟,李金梅,万美容,徐铁..自体骨髓干细胞移植治疗下肢缺血性疾病的疗效观察[J].中国全科医学,2013,16(18):2152-2156,5.
