DEEP球囊介入治疗糖尿病足的临床疗效评估

Evaluation of the Efficacy of Interventional Treatment of Diabetic Foot by DEEP Balloon

目的:评估Deep球囊扩张膝关节以下动脉及支架置入治疗糖尿病足的临床疗效及其安全性。方法:选择2007年8月～2011年8月我院收治的96例糖尿病足患者并将其随机分成A、B两组,A组(74例)使用deep球囊扩张膝关节以下细小动脉甚至足背动脉,合并股动脉狭窄者植入支架;B组(22例)单纯给以抗凝、扩血管、溶栓及相关治疗。分别观察记录和比较治疗前、后及术后1周、1、3、6、10个月患者下肢及足部皮肤颜色、温度、静息痛、足背动脉搏动、间歇性跛行、溃疡愈合情况。结果:(1)糖尿病足的血管病变多为膝关节下的动脉,包括胫前、胫后、腓动脉以及以下分支,常累及双侧数支动脉,呈阶段性分布;(2)A、B组的有效率分别为88.32%和48.63%,A组显著高于B组(P<0.05);(3)溃疡愈合情况:0-2期A组:100%愈合,B组83.72%;3-4期A组56.25%愈合,B组18.46%,对于溃疡治疗的有效率A组显著高于B组(P<0.05)。结论:Deep球囊扩张糖尿病足膝关节以下动脉联合动脉支架术治疗糖尿病足与保守治疗相比,效果明显,可恢复下肢动脉血供,明显消除和缓解静息痛、间歇性跛行,促进溃疡的愈合。降低截肢的几率。改善生活质量。

Objective： To evaluate the clinical efficacy of percutaneous transluminal angioplasty（PTA） by Deep balloon combined in patients with diabetic foot. Methods： Ninety-six patients with diabetic foot between august in 2007and august in 2011 in our hospital were randomly divided into two groups-test group （n=74）, the patients underwent PTA by deep balloon combined with TAI and control group （n=22）, the patients underwent routine treatment, such as anticoagulant therapy, antibiotics and insulin. Followed up all the pa- tients for 10 months with skin color, temperature, rest pain and dorsalis pedis artery fluctuations. Results： First, the vascular lesions of the diabetic foot, are the arteries under kneejoint, including the anterior tibial, posterior tibial, peroneal artery, and the following branches. It is often involving the bilateral number of arteries, and distribution by stepwise. The effective rate was 88.32% in test group and 48.63% in control group, There was a significant difference between the two groups （P〈0.05）. The ulcer healing situation： the 0-2 stage group A： 100%, group B： 83.72%; The 3-4 stage group A： 56.25%, group B： 18.46%, it was a significant difference between the two groups（P〈0. 05） in the efficiency of the ulcer treatment. Conclusion： The curative effect of PTA by deep balloon combined was better than the routine treatment. It could give a satisfactory prognosis, recovery of lower extremity arterial, promote the healing of ulcers and decrease of the disability rate.