血管腔内介入联合负压闭式引流治疗糖尿病足下肢动脉硬化闭塞症的效果

Effect of endovascular intervention combined with negative pressure closed drainage on diabetic foot arteriosclerosis obliterans

目的探讨血管腔内介入联合负压闭式引流治疗糖尿病足下肢动脉硬化闭塞症的临床效果。方法选取2015年3月至2017年3月山西大医院收治的糖尿病足下肢动脉硬化闭塞症患者68例,按照随机数字表法分为联合组与对照组,每组34例。对照组行常规传统治疗,联合组在对照组基础上用血管腔内介入联合负压闭式引流治疗,对比两组患者治疗前后踝肱指数的变化,治疗后随访1年,比较两组患者溃疡愈合率、截肢率、溃疡愈合天数、溃疡复发率及1年后患者行走距离情况。结果两组治疗后踝肱指数比治疗前均有上升,且联合组上述指标改善情况较对照组好,差异有统计学意义(P<0.05);联合组患者溃疡愈合天数短于对照组,术后1年单次行走距离大于对照组,差异有统计学意义(P<0.05);联合组愈合率高于对照组,截肢率以及溃疡复发率低于对照组,差异有统计学意义(P<0.05)。结论血管腔内介入联合负压闭式引流治疗糖尿病足下肢动脉硬化闭塞能提高患者踝肱指数、缩短愈合天数、提高愈合率、降低截肢率以及溃疡复发率,为临床治疗糖尿病足下肢动脉硬化闭塞提供一定的参考价值。

ObjectiveTo investigate the clinical effect of endovascular intervention combined with negative pressure closed drainage on diabetic foot arteriosclerosis obliterans.MethodsA total of 68 patients with diabetic foot and lower limb arteriosclerotic occlusion from March 2015 to March 2017 in shanxi General Hospital were selected. According to the random number table method, they were divided into the combined group and the control group, with 34 cases in each group. The control group was treated with conventional therapy, and the combined group was treated with endovascular intervention combined with negative pressure closed drainage on the basis of the treatment in the control group. The changes of ankle brachial indexes before and after treatment were compared between the two groups. After one year follow-up, the ulcer healing rate, amputation rate, ulcer healing days, ulcer recurrence rate and one year later were compared between the two groups.ResultsThe ankle brachial indexes of both groups increased after treatment compared with that before treatment, and the improvement of the above indexes in the combined group was better than that in the control group, the differences were significant (P<0.05); the days of ulcer healing in the combined group were significantly shorter than that in the control group, and the single walking distance in one year after operation was significantly greater than that in the control group, the differences were significant (P<0.05). The healing rate of the combined group was higher than that in the control group, and the amputation rate and ulcer recurrence rate were significantly lower than that in the control group (P<0.05).ConclusionsEndovascular interventional therapy combined with negative pressure closed drainage can improve the ankle brachial index, shorten the healing days, improve the healing rate, reduce the amputation rate and ulcer recurrence rate in diabetic foot and lower extremity arteriosclerosis occlusion. This provides a reference value for clinical treatment of diabetic foot arteriosclerosis obliterans.