中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
2期
123-126
,共4页
李先涛%郭平凡%庄晖%蔡方刚%张金池%刘学强%戴贻权%吴捷%詹腾辉
李先濤%郭平凡%莊暉%蔡方剛%張金池%劉學彊%戴貽權%吳捷%詹騰輝
리선도%곽평범%장휘%채방강%장금지%류학강%대이권%오첩%첨등휘
糖尿病足%临床方案%足溃疡%腔内治疗
糖尿病足%臨床方案%足潰瘍%腔內治療
당뇨병족%림상방안%족궤양%강내치료
Diabetic foot%Clinical protocols%Foot ulcer%Endovascular procedures
目的 探讨angiosome理念在糖尿病足(diabetic foot,DF)和下肢重度肢体缺血(critical limb ischemia,CLI)的临床应用及治疗策略.方法 回顾性分析2010年1月至2011年6月收治的糖尿病足(FontaineⅣ期)患者42例(48条肢体)和CLI(FontaineⅣ期)患者40例(42条肢体),分为DF组和CLI组,2组患者均按angiosome理念打通下肢病变血管,随访6个月,比较2组患者的血管病变特点及治疗效果.结果 2组患者受累血管的分布差异有统计学意义(x2 =15.115,P=0.004),CLI组中受累的股浅动脉(x2=7.981,P=0.005)及胭动脉(x2=5.026,P=0.025)显著多于DF组；2组患者技术成功率(DF组75％,CLI组76.19％,P=0.896)、临床成功率(DF组70.83％,CLI组83.33％,P=0.162)、大截肢率(DF组8.33％,CLI组7.14％,P=0.833)、死亡率(DF组7.14％,CLI组5.00％,P=0.523)差异均无统计学意义.结论 糖尿病足和CLI下肢受累血管的分布明显不同,但临床治疗效果基本相同.以angiosome理念为基础的腔内治疗能改善糖尿病足和CLI治疗的临床成功率,尚需要更多的前瞻性随机对照试验来支持angiosome理念的临床应用.
目的 探討angiosome理唸在糖尿病足(diabetic foot,DF)和下肢重度肢體缺血(critical limb ischemia,CLI)的臨床應用及治療策略.方法 迴顧性分析2010年1月至2011年6月收治的糖尿病足(FontaineⅣ期)患者42例(48條肢體)和CLI(FontaineⅣ期)患者40例(42條肢體),分為DF組和CLI組,2組患者均按angiosome理唸打通下肢病變血管,隨訪6箇月,比較2組患者的血管病變特點及治療效果.結果 2組患者受纍血管的分佈差異有統計學意義(x2 =15.115,P=0.004),CLI組中受纍的股淺動脈(x2=7.981,P=0.005)及胭動脈(x2=5.026,P=0.025)顯著多于DF組；2組患者技術成功率(DF組75％,CLI組76.19％,P=0.896)、臨床成功率(DF組70.83％,CLI組83.33％,P=0.162)、大截肢率(DF組8.33％,CLI組7.14％,P=0.833)、死亡率(DF組7.14％,CLI組5.00％,P=0.523)差異均無統計學意義.結論 糖尿病足和CLI下肢受纍血管的分佈明顯不同,但臨床治療效果基本相同.以angiosome理唸為基礎的腔內治療能改善糖尿病足和CLI治療的臨床成功率,尚需要更多的前瞻性隨機對照試驗來支持angiosome理唸的臨床應用.
목적 탐토angiosome이념재당뇨병족(diabetic foot,DF)화하지중도지체결혈(critical limb ischemia,CLI)적림상응용급치료책략.방법 회고성분석2010년1월지2011년6월수치적당뇨병족(FontaineⅣ기)환자42례(48조지체)화CLI(FontaineⅣ기)환자40례(42조지체),분위DF조화CLI조,2조환자균안angiosome이념타통하지병변혈관,수방6개월,비교2조환자적혈관병변특점급치료효과.결과 2조환자수루혈관적분포차이유통계학의의(x2 =15.115,P=0.004),CLI조중수루적고천동맥(x2=7.981,P=0.005)급연동맥(x2=5.026,P=0.025)현저다우DF조；2조환자기술성공솔(DF조75％,CLI조76.19％,P=0.896)、림상성공솔(DF조70.83％,CLI조83.33％,P=0.162)、대절지솔(DF조8.33％,CLI조7.14％,P=0.833)、사망솔(DF조7.14％,CLI조5.00％,P=0.523)차이균무통계학의의.결론 당뇨병족화CLI하지수루혈관적분포명현불동,단림상치료효과기본상동.이angiosome이념위기출적강내치료능개선당뇨병족화CLI치료적림상성공솔,상수요경다적전첨성수궤대조시험래지지angiosome이념적림상응용.
Objective To assess application and clinical results of angiosome concept in treating diabetic foot and critical lower extremity ischemia.Methods A retrospective study was made on 82 consecutive patients (42 patients with diabetic feet,40 patients with CLI) who underwent infrainguinal angioplasty or angioplasty combined with stenting guided by angiosome concept from 2010.01 to 2011.06.After 6-month follow-up was completed,the documented data including preoperative and postoperative ABI value,location of foot ulcers,distribution of culprit infrainguinal vessels,technical and clinical results were analyzed and compared using SPSS 17.0.Results There was no difference of demographical features between these two groups.Improved ABI value in DF group and CLI group were 0.20 ±0.16,0.39 ±0.11 at 6 months,respectively,P ＜ 0.001.Locations of feet ulcers did not differ between two groups (P =0.706),whilst the distribution of culprit vessels was different statistically (P =0.004),with higher rate of involved superficial femoral arteries and popliteal arteries in CLI group(P =0.005) than in DF group(P =0.005).The technical success rate (75％ in DF group,76.19％ in CLI group,P =0.896),clinical success rate(70.83％ in DF group,83.33％ in CLI group,P =0.162),major amputation rate(8.33％ in DF group,7.14％ in CLI group,P =0.833)and mortality(7.14％ in DF group,5.00％ in CLI group,P =0.523) were not significantly different in these two groups.Conclusions There is significant difference in distribution of lower extremity culprit vessels between patients of diabetic foot and CLI,with similar technical and clinical results.The endovascular therapy guided by angiosome concept may prove beneficial in terms of better wound healing and subsequent limb salvage.
