准分子激光销蚀术治疗糖尿病足膝下动脉病变的临床疗效分析

Clinical analysis of excimer laser atherectomy in the treatment of diabetic foot with infrapopliteal arteriopathy

目的探讨准分子激光销蚀术(ELA)治疗糖尿病足膝下动脉病变的临床疗效。方法回顾性分析2019年12月至2021年5月新疆维吾尔自治区人民医院采用ELA治疗的36例糖尿病足合并膝下动脉病变患者(40条患肢)的临床资料。观察ELA治疗糖尿病足膝下动脉病变的手术成功率,术后3 d及术后3、6个月的踝肱指数(ABI)、保肢(趾)率、视觉模拟评分(VAS)。结果36例患者手术均获得成功,围手术期2例出现限流性夹层、2例出现远端动脉栓塞、1例出现穿刺点血肿。术后3、6个月患者ABI较术前明显提高(均P<0.05),VAS评分较术前明显降低(均P<0.05)。术后3 d保肢(趾)率为92.5%(37/40),术后3个月保肢(趾)率为82.5%(33/40),术后6个月保肢(趾)率为77.5%(31/40)。结论ELA治疗糖尿病足膝下动脉病变安全有效,近期疗效尚可。

Objective To explore the clinical efficacy of excimer laser atherectomy(ELA)in the treatment of diabetic foot with infrapopliteal arteriopathy.Methods The clinical data of 36 patients(40 limbs)with diabetic foot complicated with inferior knee artery disease treated by ELA in Xinjiang Uygur Autonomous Region People′s Hospital from December 2019 to May 2021 were analyzed retrospectively.The success rate of ELA in the treatment of diabetic inferior genicular artery disease,ankle-brachial index(ABI),limb salvage rate and Visual Analogue Scale(VAS)score at 3 days and 3 and 6 months after operation was observed.Results All the 36 patients were operated successfully,including 2 cases of flow-limiting dissection,2 cases of arterial embolism and 1 case of hematoma at the puncture point.The ABI of patients 3,6 months after operation was significantly higher than that before operation(all P<0.05),and the VAS score 3,6 months after operation was significantly lower than that before operation(all P<0.05).The rate of limb(toe)salvage were 92.5%(37/40),82.5%(33/40)at 3 d,3 months and 77.5%(31/40)at 6 months after operation.Conclusions ELA is safe and effective in the treatment of diabetic foot infrapopliteal arteriopathy,and the recent efficacy is fair.