长球囊血管扩张成形术治疗糖尿病足的临床比较研究

Clinical comparative study of long balloon angioplasty in the treatment of diabetic foot

目的比较长球囊血管扩张成形术(PTA)与内科综合疗法治疗糖尿病足的疗效。方法选择我院糖尿病足住院患者68例,患肢105例,分为55例对照组和50例研究组,对照组患者进行内科常规降血糖、消炎、抗凝、活血化瘀及营养神经药物等综合治疗,研究组在内科综合治疗基础上联合长球囊PTA及支架置入介入治疗,观察介入治疗手术成功率及比较两组患者在治疗前与治疗后的临床症状改善情况。结果研究组50条患肢128条靶血管,靶血管治疗总有效率占85%(109/128),治疗前血管造影靶血管狭窄率为(89±8.2)%,治疗后造影靶血管狭窄率为(25±4.5)%,治疗后靶血管狭窄率明显降低,差异具有统计学意义(P<0.05)。PTA术后近期治疗临床疗效总有效率84%(42/50),且以显效为主,占54%(27/50),对照组糖尿病足治疗的总有效率为67%,差异具有统计学意义(P<0.05)。随访12个月,研究组中1例患者足部截肢,对照组中2例小腿截肢,1例足部截肢。结论长球囊PTA联合支架置入术能安全、有效地重建患者下肢血运,改善糖尿病足临床症状,且并发症少,在临床上值得广泛推广应用。

Objective To compare the efficacy of long balloon percutaneous transluminal angioplasty(PTA)with internal medicine in the treatment of diabetic foot.Methods 68 diabetic foot patients with 105 affected limbs in our hospital were divided into control group(55 cases)and study group(50 cases).The control group was treated with routine medical treatment such as lowering sugar,anti-infection,anti-coagulation,promoting blood circulation and removing blood stasis,trophic nerve,etc.The study group was treated with long balloon PTA and stent interventional therapy on the basis of comprehensive medical treatment.The success rate of interventional therapy and the improvement of clinical symptoms before and after treatment were observed.Results In the study group,128 target vessels were found in 50 affected limbs.The successful rate of target vessel therapy was 85%(109/128).The target vessel stenosis rate was(89±8.2)before treatment and(25±4.5)after treatment.The difference of target vessel stenosis rate before and after treatment was statistically significant(P<0.05).The total effective rate after PTA was 84%(42/50)in the short term.The total effective rate in the control group was 67%(P<0.05)and 54%obviously.The difference was statistically significant(P<0.05).Following up for 12 months,the study group had 1 case of foot amputation,2 cases of leg amputation and 1 case of foot amputation in control group.Conclusion Long balloon PTA and stent implantation are safe,effective and less complicated in treating diabetic foot.This is worth popularizing and applying widely in clinic.