胫骨横向骨搬移技术治疗糖尿病足的疗效分析

Analysis of Curative Effect of Tibia Transverse Bone Grafting Techniques in Treatment of Diabetic Foot

目的研究在治疗糖尿病足中应用胫骨横向骨搬移技术的临床效果。方法回顾性分析方便选取该院自2016年4月—2017年4月期间收治的50例糖尿病足患者所有资料,这50例患者包括Wagner分级:0~4级,下肢MRI或CT动脉造影均有腘动脉以下的血管闭塞、血流中断。实施胫骨横向骨搬移术治疗,术中于患者胫骨中段行2 cm×12 cm的骨窗,术后第5天对骨窗进行横向搬移,促使骨块附近软组织再生,构建全新的微循环,以便于改善患肢血供。结果对该次该院收治的50例糖尿病足患者经胫骨横向骨搬移技术治疗之后微循环重建成功,溃疡得到逐步愈合,未出现经小腿截肢情况,溃疡平均愈合时间为(13.21±1.32)周;患者患足感染、麻木、疼痛等症状均逐步消失,胫骨搬移骨窗中位愈合时间(18.23±2.22)周;术前患者足部皮温(27.23±0.32)℃、疼痛评分(5.10±0.39)分,术后患者足部皮温(31.24±0.54)℃、疼痛评分(0.78±0.08)分,差异有统计学意义(P<0.05)。结论将胫骨横向骨搬移技术应用于糖尿病足等下肢动脉闭塞症治疗中效果显著,可缓解患者疼痛,降低截肢率,提升临床治疗效果,是促进患者早日恢复健康的一种值得应用的治疗技术。

Objective To research the clinical effect of tibia transverse bone grafting techniques in treatment of diabetic foot. Methods Retrospetive andysis of all data of 50 patients with diabetic foot treated from April 2016 to April 2017,All patients included Wagner classification of level 0 to level 4, and the lower extremity MRI or CT arteriography had the vascular occlusion and blood flow interruption below the popliteal artery, and the 2 cm×12 cm bone window was performed in the middle tibia, and the bone window was for transverse grafting thus promoting the regeneration of soft tissues surrounding bones and constructing the new micro-circulation in order to improve the blood supply of affected limbs. Results After treatment, the micro-circulation reconstruction of 50 cases was successful, and the ulcer was gradually cured, and there was no below knee amputation, and the average healing time of ulcers was（13.21±1.32）weeks, and the infection, numbness and pains gradually disappeared, and the median healing time of bone window was（18.23 ±2.22）weeks, and the foot skin temperature and pain score of patients before operation were respectively（27.23±0.32）℃ and（5.10±0.39）marks and（31.24±0.54）℃,（0.78±0.08）points after operation, and the differences were statistically significant（P〈0.05）. Conclusion The effect of tibia transverse bone grafting techniques in treatment of arterial occlusive symptoms of low limbs such as diabetic foot is obvious, which can relieve the pains, reduce the amputation rate and improve the clinical treatment effect and promote the early recovery, which is worth promotion.