缺血性糖尿病足病的流行病学调查和治疗方法研究

The morbidity of ischemic diabetic foot and its treatment

目的 初步了解本院缺血性糖尿病患者足病的发病比例,并评价以血管重建术为基础的综合治疗的疗效.方法 对本院收治的糖尿病足病患者,根据体格检查、踝肱指数测定和血管影像学检查结果 筛选出下肢缺血患者,并计算其所占比例.同时予血管重建术治疗为主,结合抗感染等综合疗法,并观察疗效.结果 本组糖尿病足病患者81例,确诊为缺血性糖尿病足病11例（13.58%）,其中接受外科血管重建术治疗者10例,手术成功率为90.9%;9例患者创面愈合,2例截肢,临床成功率为81.9%.结论 明确缺血性糖尿病足病患者的流行病学特点,并予针对性治疗,可大幅提高保肢率、改善疗效.

Objective To investigate the incidence of lower limb ischemia in patients with diabetic foot disease, and to evaluate efficacy of systemic therapy based on revascularization. Methods Ischemic foot ulceration was diagnosed according to physical examination, ankle-brachial index （ABI） and vascular imagine modalities. All patients with ischemic diabetic foot received lower limb revascularization by vascular surgeon, combined with systemic management including anti-infection therapy. Results Among total 81 patients with diabetic foot during the period from October 2006 to September 2009, ischemic lesions were identified in 11 （ 13.6% ）, 10 of whom received revascularization procedure with a surgical success rate of 90.9%, and in 9 patients wounds were healed with a limb salvage （clinic success） rate of 81.8.%. The rest 2 cases underwent amputation finally. Conclusion Systemic treatment based on revascularization procedures can significantly improve limb-salvage rate for patients with ischemic diabetic foot.