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通过补液逆转下肢间歇性跛行和静息痛

Reversal of Lower-Extremity Intermittent Claudication and Rest Pain by Hydration.

作者信息

Fernández Samuel, Parodi Juan Carlos, Moscovich Fabián, Pulmari Camilo

机构信息

Trinidad Hospital, San Isidro, Buenos Aires, Argentina; Chief of Vascular Surgery, Hospital Malvinas Argentinas, Buenos Aires, Argentina.

Trinidad Hospital, San Isidro, Buenos Aires, Argentina; Chief of Vascular Surgery, Trinidad Hospital, Buenos Aires, Argentina; Adjunct Professor of Surgical Research, University of Michigan School of Medicine, Ann Arbor, MI; Honorary Professor University of Buenos Aires School of Medicine, CABA, Argentina.

出版信息

Ann Vasc Surg. 2018 May;49:1-7. doi: 10.1016/j.avsg.2018.01.074. Epub 2018 Feb 23.

Abstract

BACKGROUND

Medical treatment of disabling intermittent claudication or critical limb-threatening ischemia causing rest pain often fails or has partial response.

METHODS

In this pilot study, 36 patients (12 females) affected by disabling intermittent claudication or rest pain of the lower extremities were exposed to a daily 3-L water intake for up to 6 weeks. Cutaneous foot temperature, ankle/brachial index, time and distance of claudication, and pain intensity were recorded before and at the completion of the hydration period.

RESULTS

Patients with a mean ± SE age of 71 ± 2 years (range, 40-86) had disabling claudication (less than 100 meters) for more than 5 months while 11% reported pain at rest. A 6-week water intake of more than 2,500 mL/24 hr was achieved in 35 of the 36 patients enrolled in the study. Increased water intake was associated with significant improvements in median ankle/brachial index (from 0.60 to 0.76; P < 0.0001) and skin temperature (first dorsal right toe, from 29.95°C to 30.0°C, P < 0.001). Time and distance to report claudication of supervised treadmill exercise improved from 1.25 to 6.25 min (P < 0.0001) and from 100 meters to 535 meters (P < 0.0001), respectively.

CONCLUSIONS

This study suggests that hydration attained by daily water consumption of more than 2.5 L has a robust impact on reducing the symptoms of disabling claudication and rest pain caused by peripheral vascular disease.

摘要

背景

对于导致间歇性跛行致残或严重肢体缺血性静息痛的医学治疗往往效果不佳或仅有部分疗效。

方法

在这项初步研究中,36例(12例女性)患有间歇性跛行致残或下肢静息痛的患者,每天摄入3升水,持续6周。在水化期开始前及结束时记录足部皮肤温度、踝臂指数、间歇性跛行的时间和距离以及疼痛强度。

结果

平均年龄为71±2岁(范围40 - 86岁)的患者出现间歇性跛行致残(行走距离不足100米)超过5个月,11%的患者报告有静息痛。参与研究的36例患者中有35例在6周内实现了每日饮水量超过2500毫升/24小时。饮水量增加与中位踝臂指数显著改善相关(从0.60提高到0.76;P < 0.0001),皮肤温度也显著改善(右足第一趾背,从29.95°C提高到30.0°C,P < 0.001)。在有监督的跑步机运动中,报告间歇性跛行的时间和距离分别从1.25分钟改善到6.25分钟(P < 0.0001)和从100米改善到535米(P < 0.0001)。

结论

本研究表明,每日饮水量超过2.5升实现的水化对减轻由外周血管疾病引起的间歇性跛行致残和静息痛症状有显著影响。

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