微创截骨治疗糖尿病足的效果及对足趾血运的影响

Efficacy of Minimally Invasive Osteotomy in the Treatment of Diabetic Foot and Its Influence on Toes Blood Supply

目的:探讨微创截骨治疗糖尿病足的效果及对足趾血运的影响。方法:选取2017年1月-2020年2月于阳江市人民医院进行微创截骨治疗的80例糖尿病足患者,按随机数字表法将其分为观察组(40例)和对照组(40例),观察组给予微创截骨治疗,对照组给予负压辅助创面愈合技术治疗。比较两组治疗效果、疼痛评分、踝肱指数、患肢皮温、足背和胫后动脉血流指标及不良情况。结果:观察组创面愈合总有效率、1年后保肢率均高于对照组(P<0.05)。治疗后,两组疼痛评分均低于治疗前,踝肱指数、患肢皮温、足背和胫后动脉血流平均速度均高于治疗前,且观察组疼痛评分低于对照组,踝肱指数、患肢皮温、足背和胫后动脉血流平均速度均高于对照组(P<0.05)。观察组肌肉痉挛、肤色青紫发生率均低于对照组(P<0.05)。结论:微创截骨治疗糖尿病足具有明显效果,可缓解患者疼痛情况,改善踝肱指数,降低肌肉痉挛发生率,对足趾血运有良好的改善作用,改善患肢皮温、肤色、足背及胫后动脉血流速度。

Objective:To investigate the effect of minimally invasive osteotomy in the treatment of diabetic foot and its influence on toes blood supply.Method:A total of 80 patients with diabetic foot who underwent minimally invasive osteotomy in Yangjiang People’s Hospital from January 2017 to February 2020 were selected,they were divided into observation group(40 cases)and control group(40 cases)according to the random number table method.The observation group was treated with minimally invasive osteotomy,and the control group was treated with negative pressure assisted wound healing technology.The treatment effect,pain scores,ankle brachial index,skin temperature of affected limb,average blood flow velocity of dorsal pedal artery and posterior tibial artery,and adverse conditions were compared between the two groups.Result:The total effective rate of wound healing and limb salvage rate after 1 year in the observation group were higher than those in the control group(P<0.05).After treatment,the pain scores in both groups were lower than those before treatment,and the ankle brachial index,skin temperature of the affected limb,average blood flow velocity of dorsal pedal artery and posterior tibial artery in both groups were higher than those before treatment,and the pain score in the observation group was lower than that in the control group,and the ankle brachial index,skin temperature of the affected limb,average blood flow velocity of dorsal pedal artery and posterior tibial artery in the observation group were higher than those in the control group(P<0.05).The incidences of muscle spasm and cyanosis in the observation group were lower than those in the control group(P<0.05).Conclusion:Minimally invasive osteotomy has obvious curative effect in the treatment of diabetic foot,it can relieve pain,improve ankle-brachial index,reduce the incidence of muscle spasm,improve toes blood supply,and improve skin temperature and skin color of affected limbs,as well as the dorsal and posterior tibial artery blood flow velocities.