下肢动脉闭塞性病变对糖尿病足患者溃疡愈合的影响

Observation of the Influence of Arterio Occlusive Disease of Lower Extremities on Diabetic Foot Ulcer Rehabilitation

目的观察糖尿病患者下肢动脉闭塞性病变对糖尿病足溃疡疗效及预后的影响,为临床治疗糖尿病足溃疡提供参考。方法75例糖尿病足溃疡患者用彩色多谱勒超声诊断仪检测下肢动脉血管情况。根据检测结果分为两组:有下肢动脉闭塞性病变30例为观察组,无下肢动脉闭塞性病变45例为对照组。两组在相同病变程度和相同治疗手段的情况下,溃疡局部清创后,用敏感抗生素+普通胰岛素+生理盐水混合液换药。观察两组溃疡处肉芽组织生长时间,溃疡愈合时间及截肢率。结果PAD组溃疡面肉芽组织生长时间和溃疡愈合时间明显长于对照组(P<0.05),截肢率达16.6%;而对照组截肢率为0。结论下肢动脉闭塞性病变不仅是糖尿病足溃疡的主要原因,而且也是影响疗效及预后的重要因素。提示在处理有下肢动脉闭塞性病变的糖尿病足溃疡时,可根据病变的严重程度,采取有效的治疗措施,改善下肢动脉血流及微循环,促进局部溃疡愈合。

Objective To observe the Influence of arterio occlusive disease of lower extremities on the treatment and prognosis of diabetic foot ulcer, and thus provide some basis for the treatment of diabetic foot ulcer. Methods Color Doppler Ultrasonic examination of the lower extremity artery vascular of the 75 patients were conducted. And according to the examination results, the patients were divided into two groups, those with arterio occlusive disease into the observation group （n=30）, and those without, into the control group （n=45）. The ulcers of the two groups, with the same pathological degree and treatment, were cleansed locally, and dressing changes were done with the solution of sensitive antibiotics, common insulin and normal solution. Then observations were made of the time of granulation growth at the ulcer, of ulcer rehabilitation, and of the amputation rate. Results The time of granulation growth and ulcer rehabilitation of the observation group was markedly longer than that of the control group, and the amputation rate of the former was 16.6%, while that of the latter, 0. Conclusion Arterio occlusive disease of lower extremity is not only the main cause of diabetic foot ulcer, but also an important factor influencing the treatment effect and prognosis of the disease. This is a reminder that in the treatment of diabetic foot ulcer with arterio occlusive disease of lower extremity, lower extremity arterial blood flow and microcircuahion should be improved to facilitate the rehabilitation of the ulcer.