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目的探讨介入治疗对糖尿病足的临床疗效,为糖尿病足的治疗提供依据。方法选取25例确诊为糖尿病足的患者,在常规治疗的基础上采用插管溶栓、支架植入、球囊扩张等介入措施治疗;观察介入治疗后糖尿病足的改善情况。结果 25例糖尿病足患者中,15例(60%)患者为多部位血管狭窄,单部位血管狭窄中腘动脉最常见;25例糖尿病足患者中,23例接受介入手术,介入手术成功率为100%,手术时间50~140 min,平均(70.5±22.6)min。患者临床疗效明显,术后足部皮肤血液供应得到改善,温度明显升高,足背动脉搏动增强。患者均未出现血肿、内支架移位、血管壁破裂及血管栓塞等并发症;另有7例患者术后出现疼痛反应,但对症治疗后症状基本消失。6个月后数字减影血管造影(DSA)复查,介入治疗患者血管狭窄情况明显好转且管腔直径≥正常管腔50%,且未见血管再狭窄或闭塞等情况;另有5例原准备截肢的患者,经介入治疗后取消截肢手术。结论在糖尿病患者病情控制的前提下,及时适当地采用介入治疗措施可以有效改善糖尿病足的症状,降低截肢率。
Objective To investigate the clinical effect of interventional therapy on diabetic foot and provide basis for the treatment of diabetic foot. Methods Twenty-five patients with diabetic foot were selected and treated by interventional therapy including intubation, stent implantation and balloon dilation. The improvement of diabetic foot after interventional therapy was observed. Results Of the 25 patients with diabetic foot, 15 (60%) had multiarterial vascular stenosis and the most common stenosis was in single stenosis. Of the 25 patients with diabetic foot, 23 received interventional operation and the success rate of interventional operation was 100 %, The operation time was 50 ~ 140 min, the average was (70.5 ± 22.6) min. Patients with significant clinical efficacy, postoperative skin skin blood supply has been improved, the temperature was significantly increased, increased dorsalis pedis artery pulse. No hematoma, stent dislocation, rupture of the blood vessel wall and embolization of blood vessels occurred in all patients. Another 7 patients developed postoperative pain response, but symptoms disappeared after symptomatic treatment. After 6 months of digital subtraction angiography (DSA) review, interventional treatment of patients with vascular stenosis was significantly improved and the lumen diameter ≥ 50% of the normal lumen, and no vascular restenosis or occlusion, etc .; another 5 cases of the original preparation Amputation patients, after amputation surgery to cancel the amputation. Conclusion Under the premise of controlling the condition of patients with diabetes, timely and appropriate intervention measures can effectively improve the symptoms of diabetic foot and reduce the rate of amputation.