CT血管成像技术结合介入术治疗糖尿病足的效果观察及对氧化应激反应的影响

CT angiography combined with interventional therapy for diabetic foot and its effect on oxidative stress markers

目的观察CT血管成像技术结合介入术治疗糖尿病足的临床效果及氧化应激反应的影响。方法选取纳入该研究患者80例,均为2017年12月至2019年6月于山东省新汶矿业集团有限责任公司中心医院就诊的糖尿病足患者。按随机双盲法分为两组,即对照组(n=40,开放手术)及观察组(n=40,CT血管成像技术结合介入术),比较两组患者术前、术后氧化应激反应[超氧化物歧化酶(SOD)、一氧化氮(NO)、脂质过氧化物(MDA)、一氧化氮合酶活性(iNOS)]及术后并发症发生情况。结果观察组手术治疗成功率为100.0%,对照组手术治疗成功率为95.0%,差异无统计学意义(χ2=0.513,P=0.474);观察组手术时间[(28.49±3.64)min]、术中出血量[(2.13±0.47)mL]、肢体活动时间[(1.24±0.51)d]、住院时间[(2.17±0.24)d],均低于对照组[(52.47±5.18)min、(57.42±6.87)mL、(2.86±0.63)d、(6.45±0.52)d],差异均有统计学意义(t=23.955、50.782、25.349、47.265,均P<0.05);观察组术后并发症发生率为5.00%,低于对照组的27.50%,差异有统计学意义(χ2=5.878,P=0.015);观察组术后7 d SOD[(354.26±21.83)U/L]、NO[(41.95±6.43)μmol/L]、iNOS[(77.12±1.86)U/L]、MDA[(11.68±2.59)nmol/L]与对照组[(355.11±32.78)U/L、(42.05±8.42)μmol/L、(78.22±1.85)U/L、(11.55±2.45)nmol/L]差异均无统计学意义(均P>0.05)。结论采用CT血管成像技术结合介入术治疗糖尿病足,具有较好的治疗效果,能降低术后并发症发生率,促进患者术后较快恢复,但会增加患者术后氧化应激反应,因此介入术后需使用抗氧化应激药物改善患者预后,提高介入治疗效果。

Objective To investigate the clinical effect of CT angiography combined with interventional therapy in the treatment of diabetic foot.Methods A total of 80 patients with diabetic foot who were treated at the Central Hospital of Shandong Xinwen Mining Group Co.,Ltd.from December 2017 to June 2019 were selected in the study.The patients were divided into two groups according to random double-blind method,with 40 cases in each group.The control group received open surgery,and the observation group received CT angiography combined with interventional surgery.The oxidative stress reactions[superoxide dismutase(SOD),nitric oxide(NO),lipid peroxide(MDA),nitric oxide synthase activity(iNOS)]before and after surgery,and postoperative complications were compared between the two groups.Results The success rate of surgical treatment in the observation group was 100.0%,which in the control group was 95.0%,the difference was not statistically significant(χ2=0.513,P=0.474).The operation time[(28.49±3.64)min],intraoperative blood loss[(2.13±0.47)mL],limb activity time[(1.24±0.51)d],hospital stay[(2.17±0.24)d]in the observation group were lower than those in the control group[(52.47±5.18)min,(57.42±6.87)mL,(2.86±0.63)d,(6.45±0.52)d],the differences were statistically significant(t=23.955,50.782,25.349,47.265,all P<0.05).The incidence of postoperative complications in the observation group was 5.00%,which was lower than that in the control group(27.50%),the difference was statistically significant(χ2=5.878,P=0.015).At postoperative 7d,the levels of SOD,NO,iNOS and MDA in the observation group were(354.26±21.83)U/L,(41.95±6.43)μmol/L,(77.12±1.86)U/L,(11.68±2.59)nmol/L,respectively,which in the control group were(355.11±32.78)U/L,(42.05±8.42)μmol/L,(78.22±1.85)U/L,(11.55±2.45)nmol/L,respectively,the differences were no statistically significant between the two groups(all P>0.05).Conclusion CT angiography combined with interventional therapy in the treatment of patients with diabetic foot has high success rate of surgery,which can reduce the incidence of postoperative complications,and promote recovery of patients after surgery.However,CT angiography combined with intervention will increase the oxidative stress response of patients after surgery.Therefore,anti-oxidative stress drugs should be used to improve the prognosis of patients and improve the effect of interventional therapy.