经皮腔内血管成形术在糖尿病足治疗的临床应用

Percutaneous transluminal angioplasty in the treatment of diabetic foot

目的探讨经皮腔内血管成形术(percutaneous transluminal angioplasty,PTA)在糖尿病足治疗中的价值。方法对32例临床诊断糖尿病足的患者行患侧肢体下肢数字减影血管造影(DSA)技术,并对狭窄处实施PTA,术后给予控制血糖,抗感染,抗凝治疗,其中4例6个月后行血管造影对比观察。结果在动脉造影中,4例病人显示有狭窄,血管直径<50%,在28例狭窄>50%的病人中,23(82.1%)进行了PTA。在2例病人中(8.7%)仅在近端主干施行了PTA。11(47.8%)病人仅在下主干施行了PTA,10(43.5%)在股及下主干施行了PTA。PTA之后,患肢动脉血液灌注获得明显的改善。仅在3例病人中出现临床复发。其中2例成功进行了第二次PTA。进行过PTA的23例病人中,1(4.3%)进行了踝上截肢术。结论作为一项高度准确的成像技术和微创治疗方法,经皮腔内血管成形术(PTA)可用于治疗大多数糖病病人的局部缺血性足溃疡。对于足部血管再生是极为有效的。

Objective To evaluate the value of percutaneous transluminal angioplasty（PTA） in the treatment of diabetic foot.Methods 32 patients with clinical diagnosis of diabetic foot received digital subtraction angiography（DSA）,and PTA was done for treatment of arterial stenosis.Control of blood glucose,anti-infective,anticoagulant therapy was done after PTA.For cases received second angiography 6 month after PTA.Results In arterial angiography,there were 4 patients with arterial stenosis50%,and 28 cases with a narrow50%,in which 23（82.1%） received PTA.the The limb arterial blood perfusion was significantly improved after PTA.Only three cases occurred clinical relapse,of which 2 were successfully carried out a second PTA.In 23 patients received PTA,1（4.3%） had amputation in the ankle.Conclusion It is a highly accurate imaging techniques and minimally invasive treatment of percutaneous transluminal angioplasty（PTA） for the treatment of most of the diabetic patients with ischemic foot ulcers.