血管腔内联合介入治疗糖尿病足性血管病变

Interventional therapy through PTA combined with stent implantation for the treatment in vascular lesions of the diabetic foots

目的探讨经皮腔内血管成形术(PTA)联合支架植入术治疗糖尿病足下肢血管病变的疗效性和安全性。方法 18例糖尿病足血管病变患者,Fontaine分期Ⅱ-Ⅳ期,采用经皮股动脉穿刺法,行糖尿病足下肢动脉PTA术,同时联合支架植入术。观察术后1周、1个月、3个月、6个月的皮肤温度、踝肱指数(AnkleBrachialIndex,ABI)、间歇性跛行距离改善情况。结果所有18例病人,靶血管共26条,全部行PTA,同时联合支架植入6枚。PTA成功率91.4%,皮肤温度、踝肱指数、跛行距离分别较术前增加。与术前相比较,下肢缺血症状明显改善。结论经皮腔内血管成形术联合支架植入术,可作为治疗糖尿病足严重肢体缺血患者的首选治疗方法,安全、有效,值得临床应用和进一步推广。

Object To investigate the effi cacy and safety of therapy through PTA combined with stent implantation for the treatment in vascular lesions of the diabetic foots. Methods Eighteen patients with vascular lesions of diabetic foots and Fontaine degreeⅡ-Ⅳ,PTA combined with stent implantation were performed through percutaneous puncture femoral artery. The flowed up data included skin temperature,intermittent claudicated distances and ABI at 1 week,1 months,3 months,and 6 months after operation. Result PTA was performed in all eighteen patients and stent implantation in six patients for targeted vessels. The success rate of PTA was 91.4%,skin temperature,intermittent claudicated distances and ABI had were signifi cantly increased compared with pre-operation,Lower limb ischemia be signifi cantly improved. Conclusion PTA combined with stent implantation is an effective and safety method for the treatment in vascular lesions of the diabetic foots. It is worth applying in the clinic,further to be spreaded.