糖尿病足血管腔内治疗的近期疗效观察

Clinical observation on short-term curative efficacy of endovascular treatment in treating diabetic foot

目的：评价糖尿病足（DF）血管腔内治疗的近期临床疗效和安全性。方法2013年1-12月收治的40例（46条患肢） DF患者接受血管腔内治疗。观察患者术后的技术成功率和并发症发生率，分析患者术后1周、1个月、3个月和6个月的临床症状、踝肱指数（ABI）和累积通畅率。结果成功开通患肢43条，技术成功率为93.5%。9例（22.5%）患者出现并发症。40例患者均获随访。技术成功的患肢术后临床症状较术前明显改善；术后1周、1个月、3个月和6个月的平均ABI分别为（0.91±0.18）、（0.87±0.25）、（0.84±0.15）和（0.75±0.21），与术前（0.31±0.21）比较差异均有统计学意义（P〈0.05）。术后6个月的一期通畅率、辅助通畅率和二期通畅率分别为78.4、81.6%、88.3%。结论糖尿病足血管腔内治疗是可行、安全、有效的，但其长期疗效有待进一步观察。

Objective To evaluate the short-term curative clinical efficacy and the safety of endovascular treatment in treating diabetic foot. Methods The endovascular treatments of 40 patients （46 limbs） with diabetic foot were retrospectively reviewed from Jan. 2013 to Dec. 2013. The rates of technical success and complication were evaluated. Postoperative clinical symptoms, ankle-brachial index （ABI） and cumulative primary patency rates were evaluated 1 week, 1, 3 and 6 months after operation. Results The initial technical success was 93.5%（43 lower limbs） with a complication rate as 22.5%（9 cases）. All 40 patients were followed up. The clinical symptoms were relieved in patients after successful endovascular treatment. The average ABI was （0.91±0.18）, （0.87±0.25）, （0.84±0.15） and （0.75±0.21） 1 week, 1, 3, 6 months after operation, respectively, which were significantly higher than preoperative ABI （0.31±0.21）, P〈0.01. Six months after operation, the primary, assisted-primary, and secondary patency rates were 78.4, 81.6%and 88.3%, respectively. Conclusion The Endovascular treatment in diabetic foot is a feasible, safe and effective procedure. However, the long term outcome needs to be observed in the future.