胫骨横向骨搬移技术治疗糖尿病足的临床研究

Clinical study on the treatment of diabetic foot with transversal tibial bone transfer technique

目的:探讨胫骨横向骨搬移技术在治疗糖尿病足的临床应用及其临床意义。方法:回顾性分析骨科在进行胫骨横向骨搬移治疗的11例Wagner分期3、4期糖尿病足患者的临床资料。结果:11例患者均获得随访,随访时间6~11个月,所有糖尿病足溃疡创面均得到愈合(全部保肢)。与术前相比,术后患者第3周和第6周的视觉模拟评分(VAS)、患肢足表皮温度、踝肱指数、血清中血管内皮生长因子(VEGF)及血小板源性生长因子(PDGF)均有明显改善,且术后两次随访结果比较,亦变化明显。结论:胫骨横向骨搬移技术对于治疗Wagner3、4期的糖尿病足患者具有较好的临床效果,早期可形成血清血管生成相关因子的表达度增加,提高创面愈合概率,降低截肢率,减轻患者痛苦,提高患者的生活质量,是一种值得推广的技术。

Objective:To investigate the clinical application and significance of transverse tibial bone transfer in the treatment of diabetic foot.Methods:The clinical data of 11 Wagner patients with stage 3 and stage 4 diabetic foot treated by transverse tibial bone transfer were analyzed retrospectively.Results:All the 11 patients were followed up for 6~11 months.All diabetic foot ulcer wounds were healed(all limbs were preserved).The visual analogue scale(Vas),foot epidermal temperature,ankle-brachial index(Abi),Serum Vascular endothelial growth factor and platelet-derived growth factor(PDGF)were significantly improved at the 3rd and 6th Week postoperatively,the results of two follow-up after the operation were also significantly different.Conclusion:transverse tibial bone transfer technique is effective in the treatment of diabetic foot patients with WAGNER3 and 4 stage.The expression of angiogenesis-related factors increases in the early stage,which increases the rate of wound healing and decreases the rate of amputation,it is a technique worth popularizing to relieve patients'pain and improve patients'quality of life.