经皮血管腔内血管成形术在糖尿病膝下病变中应用及经验探讨

Clinical effect of percutaneous transluminal angioplasty on the treatment of diabetic patients with infrapopliteal arterial disease and related experience

目的:评价糖尿病膝下动脉病变经皮腔内血管成形术的临床疗效。方法:本组371例糖尿病合并缺血性下肢动脉病变患者,男230例,女141例,年龄48~88岁,平均年龄69岁。所有患者术前均行患肢CTA三维重建及DSA检查,435肢共612支膝下动脉行PTA术。术后定期门诊复查,观察纪录临床症状和体征变化,1、3、6和12个月测定ABI。结果 :330例患者的591个分支成功地开通,所有患者的疼痛症状均明显缓解,术后12个月ABI平均指数为0.66±0.16,较治疗前明显改善(P<0.05)。结论 :经皮腔内血管成形术是治疗糖尿病膝下动脉病变的安全有效的手术方法 。

Objective： To investigate the clinical effect of percutaneous transluminal angioplasty （PTA） in the treatment of diabetic patients with infrapopliteal arterial disease. Methods： A total of 371 diabetic patients with ischemic lower limb arterial disease were enrolled, among whom there were 230 male and 141 female patients aged 48 - 88 years （mean 69 years）. All patients underwent computed tomography angiography with three- dimensional reconstruction and digital subtraction angiography for the affected limbs before surgery, and PTA was performed for 435 limbs with a total of 612 infrapopliteal arteries. Regular reexamination was performed after surgery to observe and record the changes in clinical symptoms and signs, and ankle-brachial index （ABI） was measured at 1, 3, 6, and 12 months. Results： A total of 591 arterial branches in 350 patients were successfully recanalized. All patients achieved significant remission of pain and had a significant improvement in ABI at 12 months after surgery （0.66 ± 0.16, P 〈 0.05）. Conclusions： PTA is a safe and effective technique for the treatment of diabetic patients with infrapopliteal arterial disease.