糖尿病足下肢血运重建技术与治疗策略

Blood supply reconstruction technology and treatment strategy of lower limbs in diabetes foot

随着糖尿病患病率逐年升高,患有糖尿病的慢性威胁性肢体缺血(chronic limb-threatening ischemia,CLTI)的发病率也呈上升趋势。在多达50%的糖尿病足溃疡患者中可以观察到外周动脉疾病(peripheral arterial disease,PAD)的症状或体征,同时PAD也是伤口愈合不良和截肢的危险因素。治疗患有糖尿病的PAD患者更困难,因为其更易发生长节段闭塞、严重钙化且更多累及远端。因此,针对这些患者的治疗策略与其他PAD患者应该有所区分。最近研究强调了糖尿病足患者的不同血运重建方法、治疗技术、设备及其疗效,这些治疗方式与技术有望缓解缺血性疼痛,治愈足部溃疡,降低截肢率和缩小截肢范围,并改善患者的功能和生活质量。本文对糖尿病足患者下肢血运重建不同治疗方式临床数据进行分析,讨论不同方式的优点,详细介绍糖尿病足下肢血运重建策略,还关注了可用于糖尿病足下肢血运重建的最新治疗技术和设备,旨在提供较为全面的糖尿病足下肢血运重建研究进展。

Chronic limb-threatening ischemia(CLTI) in people with diabetes is on the rise as the prevalence of diabetes increases. Symptoms or signs of peripheral arterial disease(PAD) can be observed in up to 50% of patients with diabetic foot ulcers,and PAD is also a risk factor for poor wound healing and amputation. Treatment of PAD patients with diabetes is more difficult because they are more prone to long-segment occlusion, severe calcification, and more distal involvement. Therefore, treatment strategies for these patients should be differentiated from other PAD patients. Several recent studies have highlighted different revascularization approaches, treatment techniques, devices, and their efficacy in diabetic foot patients, which promise to relieve ischemic pain, heal foot ulcers, reduce the rate and extent of amputation, and improve patient outcomes. function and quality of life.This review analyzes the clinical research data of different treatment methods for lower extremity revascularization in diabetic foot patients, discusses the advantages of different methods, and introduces the strategies of diabetic foot lower extremity revascularization in detail. The latest treatment techniques and equipment aim to provide readers with a more comprehensive research progress on revascularization of the lower extremity of the diabetic foot.