以腔内技术为基础的糖尿病足一站式综合治疗

Diabetic foot one -step overall treatment based on transluminal technology

目的：探讨以腔内技术为基础的一站式综合技术对糖尿病足溃疡的改善情况。方法82例糖尿病足溃疡患者给予腔内动脉成形术开通血流，强化控制血糖，应用敏感抗生素，蚕食清创，按创面床准备理论、湿性疗法清创换药，创面大的患者结合负压吸引治疗。结果82例患者85条下肢行经皮选择性动脉成形术，成功率100．0％。共116处溃疡面，有效106例（91．4％），无效10例（8．6％）。踝肱指数（ABI）由术前的（0．41±0．12）提高到术后的（0．75±0．09）。经皮氧分压（TcPaO2）值由术前的（14．6±4．8）mmHg 提高到术后的（51．6±8．9）mmHg。结论在内分泌科应用多学科技术、一站式综合治疗糖尿病足溃疡，明显提高了糖尿病足溃疡的愈合，降低了患者的截肢率。

Objective To investigate one -step overall treatment to improve the condition of diabetic foot ulcers based on transluminal technology.Methods The patients with diabetic foot ulcers were treated with percutaneous transluminal angioplasty（PTA）to open blood flow,intensively control patients＆#39;blood glucose,application of sensitive antibiotics,erode debridement and dressing change according to wound bed preparation（WBP）and moist wound heal, vacuum aspiration was applied in large wound.Results Eighty -two patients（eighty -five lower limbs）underwent PTA,the successful rate was 100.0%.Of 116 ulcers,106 cases were effective （91.4%）,10 cases were invalid （8.6%）.Their ankle -brachial index （ABI）increased from preoperatively （0.41 ±0.12）to postoperatively （0.75 ± 0.09）.Transcutaneous oxygen pressure（TcPaO2 ）increased from preoperatively （14.6 ±4.8）mmHg to postopera-tively （51.6 ±8.9）mmHg.Conclusion One -step treatment regarding multi disciplinary team on endocrine section can improve the treatment of diabetic foot and lower the amputation rate.