糖尿病性膝以下动脉病变单纯球囊扩张治疗半年随访观察

Interventional therapy on diabetic foot with below-knee artery disease:half year follow-up investigation

目的:观察糖尿病膝以下动脉病变患者单纯球囊扩张治疗半年内的疗效.方法:对31例糖尿病膝以下动脉病变患者38条患肢进行下肢血管球囊扩张治疗,观察术前、术后1wk,1和6mo下肢疼痛程度、足背皮温、踝臂指数(ABI)及血管超声的变化.结果:①膝以下多支动脉病变患肢占63.16%,动脉病变以重度为主;②术后1wk,1和6mo的疗效有效率分别为84.21%,89.47%,75.67%,ABI、足背皮温较术前增加,下肢血管超声示局部血管内径无明显差异,股动脉、股浅动脉、腘动脉和足背动脉的血流速度均较术前明显增加(P<0.05).但术后6mo的上述指标较术后1wk和1mo有所回落.③半年肢体存活率为100%.结论:单纯球囊扩张治疗对糖尿病膝以下动脉病变患肢有良好疗效,下肢动脉血供、ABI、足背皮温、间歇跛行以及静息痛均有所好转,半年病残率为0.

AIM： To investigate the effect of pereutaneous transluminal angioplasty on diabetic patients with below-knee artery disease in half a year. METHODS： With percutaneous transluminal angioplasty on 38 lower extremities of 31 diabetic patients, the changes in low-limb pains, foot temperature, ankle-brachial index （ABI） and ultrasound evaluation were investigated and analyzed before and 1 week, 1 month and 6 months after treatment. RESULTS： （1）63.16% was triple vessel disease. The majority of below-knee arteries were severely stenosed; （2） The efficient rates in 1 week, 1 month and 6 months after interventional therapy were 84.21%, 89.47% , 75.67%. ABI and the foot temperature were both higher after therapy. Under keeping the same size of the inner diameter in femoral, superficial femoral, popliteal and medio arteries after therapy, the ultrasound evaluation of low-limb arteries showed that the blood flow speed in these arteries was increased significantly （ P 〈 0.05 ）. But all above indicators were partly regressed in 6 months, compared with 1 week and 1 month after percutaneous transluminal angioplasty. （3） The low-limb survival rate of 6 months was 100%. CONCLUSION： The treatment of pereutaneous transluminal angioplasty is effective on diabetic patients with below-knee arterial disease. The blood supply, degree of ABI, foot temperature, intermitten claudication and rest pain are all mended well. The low-limb deformity rate was 0 within half a year after treatment.