糖尿病足下肢动脉病变的介入治疗效果分析

Clinical effect exploration of interventional therapy for the peripheral vascular disease in the patients with diabetic foot

目的分析介入治疗对糖尿病足下肢动脉病变的临床效果。方法对120例糖尿病足患者共141条患肢行血管介入治疗。分析病变血管、Fontaine分级与介入治疗效果的关系。术后1、3、6个月进行随访。观察患者术后并发症发生情况、术后踝-肱指数(ABI)变化及再狭窄率。结果髂动脉病变和股腘动脉病变介入治疗手术成功率明显高于膝下动脉病变和多节段病变(P<0.05);141条患肢的治疗有效率为76.60%,根据Fontaine分级Ⅰ、Ⅱ级患者治疗有效率均为100.00%,明显高于Ⅲ、Ⅳ级患者(69.05%,53.49%)(P<0.05),Ⅲ、Ⅳ级患者治疗有效率比较无显著差异(P>0.05);介入治疗术后并发症发生率为14.17%;术后各随访时间点ABI均明显高于术前(P<0.05);术后17例患者出现治疗血管再狭窄及闭塞,再狭窄率为14.17%。结论介入治疗可有效疏通糖尿病足患者下肢动脉狭窄或闭塞,安全,微创,效果良好。该方法对髂动脉及股腘动脉治疗效果最好,Fontaine分级越低,治疗效果越好。

Objective To analyze the clinical effect of interventional therapy on lower limbs arterial disease of diabetic foot. Method There were 120 patients with diabetic foot, total 141 sick lower limbs accepting interventional therapy. Analyzed the relationship among pathological vessels, Fontaine degree and the effect of interventional therapy. Observed the postoperative complications, ABI value and the restenosis rate after 1, 3 and 6 months follow-up. Result The effective rate ofinterventional therapy for common iliac artery pathology and femoral-popliteal artery pathology were obviously higher than the effective rate for inferior genicular artery pathology and multilevel disease （P 〈 0.05）; in the 141 sick lower limbs, the total effective rate was 76.60%. The effective rate of Ⅰ degree and Ⅱ degree patients both were 100.00%, and obviously higher than Ⅲ degree and Ⅳ degree patients （69.05%, 53.49%） （P 〈 0.05）. There was no significant difference in the efficiency of treatment in patients with grade Ⅲand Ⅳ （P 〉 0.05）; the incidence of postoperative complications was 14.17%; postoperative follow-up time points ABI were significantly higher than preoperative （P 〈 0.05）; there were 17 cases with artery stenosis and occlusion after therapy and the restenosis rate was 14.17%. Conclusion Interventional therapy is helpful for the stenosis or occlusion artery in the diabetic foot patients, and it shows its advantages of safety, minimally invasive and good effect. Interventional therapy has best treatment effect for the common iliac artery, femoral-popliteal artery and the patients with low Fontaine degree.