糖尿病性下肢缺血性血管病的外科治疗

Surgical therapy of diabetic ischemic angiopathy of lower limb

目的:探讨糖尿病性下肢缺血性血管病的治疗方法。方法:对24例Ⅰ型糖尿病患者合并下肢动脉缺血性疾病的39条肢体体进行了手术,其中动脉旁路手术31例,占79%。对3例患者进行了下肢截肢处理。结果:接受动脉旁路手术的患者出院时动脉血流均保持通畅。一例51岁男性患者四肢肿胀、变黑,经治疗无效死亡。结论:糖尿病性缺血性血管病可以通过外科手术治疗。如下肢远端动脉旁路移植、腔内血管成型术等。外科治疗的方法正在探讨阶段,研究方法不断进展。外科治疗不仅可以挽救肢体或降低截肢平面,而且可为足部创面的愈合提供较好的营养环境,有利于创面的愈合和提高生活质量。

Objective： To investigate the surgical therapy of diabetic ischemic angiopathy（DIA） of lower limb artery（ILA）. Methods： 39 limbs of 24 eases of insulin - dependent diabetes mellitus（IDDM） combined with DIA of LIA were operated on, of which, 31（79%） cases were given arterial bypass opemtion（ABO） and 3 cases amputation of lower limb. Results： The arterial blood flow of the patients performed ABO was all in good state when they were discharged from the hospital, but a 51 - year - old male patient with IDDM died of severe limb＇s swelling ＆ blackening. Conclusion： DIA could be cured by surgical therapy such as lower limb distal artery bypass transplant and intracavitary blood vessel plastic operation, which can not only save the patients＇ limbs or lower amputing plane but also benefit the healing of podalic surface of the wound and improve the patients＇ living quality. Surgical therapeutic method is being probed and developed.