血管成形术介入治疗糖尿病下肢血管病变的临床效果分析

Clinical Efficacy of Angioplasty Intervention in the Treatment of Diabetic Lower Extremity Vascular Lesions

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下肢血管病变的临床效果及安全性。方法:选择2008年3月至2011年12月在我院内分泌科接受治疗的2型糖尿病合并糖尿病足的患者36例,将其随机分为观察组(19例)和对照组(17例)。观察组19例患者中,14例行PTA术,4例行PTA+腔内支架植入术,1例行截肢术;对照组17例患者,全部采用传统方法进行治疗。观察和比较两组患者术后的糖尿病下肢血管病变的特点、临床效果及并发症的发生情况。结果:观察组19例患者,共40条靶血管,实施PTA手术的成功率为87.5%。采用两种治疗方法 2周或4周后,患者的临床症状和体征均得到一定程度的缓解,且均未观察到明显的不良反应。与对照组相比,接受介入治疗的患者,其临床症状的缓解率明显升高,其中在2周时介入治疗对麻木和紫绀症状的缓解尤其显著,和对照组之间有统计学差异(P<0.05)。结论:血管成形术介入治疗糖尿病下肢血管病变是一种安全可靠的方法,治疗效果好,安全性高,值得临床推广。

Objective： To investigate the efficacy of percutaneous transluminal angioplasty（PTA） combined with stent implantation in the treatment of vascular lesions of patients with diabetes. Methods： 36 cases who were diagnosed and treated in the department of endocrinology of our hospital from March 2008 to December 2011 were selected and randomly divided into the observation group（19 cases） and the control group（17 cases）. In the observation group, 14 patients were treated by PTA, 4 patients were treated by PTA combined with stent implantation, and another one was treated by amputation. In the control group, all of the 17 patients were treated by the conventional method. The characteristics of vascular lesion of lower extremities, clinical efficacy and complications were observed and compared between two groups. Results： Nineteen patients（40 target vessel） accepted interventional therapy, the successful rate was 87.5%. The symptoms and physical signs were obviously relieved after the therapy of PTA or conventional method, and no obvious adverse reactions were observed. Compared with control group, the remission rates of symptoms and physical signs in observation group were higher than that in control group, and there were statistically significant difference in the relief of numbness and cyanosis（P〈0.05）. Conclusion： It is suggested that the PTA is a safe and reliable method to treat the vascular lesions of diabetics patients with the advantages of high successful rate, better efficacy and lower incidence of complications. It is worthy of being popularied in clinic.