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目的:评估Deep球囊扩张膝关节以下动脉及支架置入治疗糖尿病足的临床疗效及其安全性。方法:选择2007年8月～2011年8月我院收治的96例糖尿病足患者并将其随机分成A、B两组,A组(74例)使用deep球囊扩张膝关节以下细小动脉甚至足背动脉,合并股动脉狭窄者植入支架;B组(22例)单纯给以抗凝、扩血管、溶栓及相关治疗。分别观察记录和比较治疗前、后及术后1周、1、3、6、10个月患者下肢及足部皮肤颜色、温度、静息痛、足背动脉搏动、间歇性跛行、溃疡愈合情况。结果:(1)糖尿病足的血管病变多为膝关节下的动脉,包括胫前、胫后、腓动脉以及以下分支,常累及双侧数支动脉,呈阶段性分布;(2)A、B组的有效率分别为88.32%和48.63%,A组显著高于B组(P<0.05);(3)溃疡愈合情况:0-2期A组:100%愈合,B组83.72%;3-4期A组56.25%愈合,B组18.46%,对于溃疡治疗的有效率A组显著高于B组(P<0.05)。结论:Deep球囊扩张糖尿病足膝关节以下动脉联合动脉支架术治疗糖尿病足与保守治疗相比,效果明显,可恢复下肢动脉血供,明显消除和缓解静息痛、间歇性跛行,促进溃疡的愈合。降低截肢的几率。改善生活质量。
OBJECTIVE: To evaluate the clinical efficacy and safety of the following arteries and stents implanted in the deep balloon dilated knee joint for the treatment of diabetic foot. Methods: Ninety-six patients with diabetic foot admitted to our hospital from August 2007 to August 2011 were randomly divided into A and B groups. A group (74 cases) underwent deep balloon dilatation of the following arteries Dorsal artery and femoral artery stenosis were implanted into the stent. Group B (n = 22) was given anticoagulation, vasodilation, thrombolysis and related treatment. The color, temperature, resting pain, dorsalis pedis artery pulsation, intermittent claudication and healing of ulcer were observed and recorded in the patients with lower extremities and feet at 1 week, 1, 3, 6 and 10 months after operation respectively . Results: (1) The vascular lesions of diabetic foot were mostly arteries in the knee joint, including the anterior tibial, posterior tibial and peroneal arteries and the following branches, often involving the bilateral branch arteries and showing a phased distribution. (2) A, B The effective rates of the two groups were 88.32% and 48.63%, respectively, which were significantly higher in group A than those in group B (P <0.05). (3) The healing of ulcer: 0-2 group A: 100% healed, 83.72% In group A, 56.25% healed in group A and 18.46% in group B, and the effective rate of treatment for ulcer was significantly higher in group A than in group B (P <0.05). Conclusion: Compared with conservative treatment, Deep balloon dilatation of diabetic foot below artery and artery stent in the treatment of diabetic foot has obvious effect and can restrain blood supply of lower extremity arterial blood supply, obviously eliminating and relieving rest pain, intermittent claudication and promoting ulcer heal. Reduce the chance of amputation. Improve the quality of life