糖尿病足介入综合诊治临床指南(第九版)

Clinical guidelines for comprehensive interventional management of the diabetic foot(9th Edition)

糖尿病足作为糖尿病血管病常见并发症之一,具有高发病率、高致残率、高致死率和治愈率低的特点,严重影响糖尿病患者的身心健康和生活品质,却一直缺少统一的规范性治疗方法。中国糖尿病足细胞与介入治疗技术联盟曾于2015年制定了糖尿病足介入综合诊治临床指南(第一版),在一定程度上填补了国内糖尿病足规范性治疗的空白,对于提高我国糖尿病足治疗水平起到了支撑作用。近10年来,随着诊断标准和治疗方式的更新,以及国内外相关研究的不断深入,联盟组织国内89家单位在第八版的基础上进行新的修订,并颁布第九版指南,以期进一步规范我国糖尿病足临床诊治工作。本指南较第八版主要增加了糖尿病足下肢动脉狭窄或闭塞的腔内治疗原则,强调血管重建优先重建直线血流的原则,至少建立1支能够从股浅动脉起始端到达足部病变部位的直接供血动脉,对于膝下动脉多支病变治疗时建议遵循“先易后难”的重建原则,先处理容易开通的病变动脉,保证至少有1支血管能够供应到足部。同时本版指南介绍了同济大学“五点法皮温”设备在糖尿病足诊治中的巨大应用价值。

Diabetic foot has been one of the most common complications of diabetes mellitus.Clinically,diabetic foot is characterized by high incidence,high disability rate,high mortality and low cure rate,which seriously affect the physical and mental health and the quality of life of diabetic patients,but its unified and normative treatment approach has been lacking.China Diabetic Foot Cellular and Interventional Technology Alliance formulated the Clinical Guidelines for Comprehensive Diagnosis and Treatment of Diabetic Foot Intervention in 2015(the first edition),which filled the gap of the domestic standardization of diabetic foot treatment and played an important role in improving its treatment level in China.In the past 10 years,with the updating of diagnostic standards and treatment methods as well as the deepening of related research at home and abroad,the Alliance has organized 89 medical units in China to formulate a new revision on the basis of the 8th edition and to issue the 9th edition guidelines,so as to further standardize the clinical diagnosis and treatment of diabetic foot in China.Compared with the 8th edition guidelines,the the 9th edition guidelines mainly adds the principles of endovascular treatment of lower limb artery stenosis or occlusion in diabetic foot,emphasizing that vascular reconstruction should give priority to the reconstruction of straight-line blood flow,and at least one direct blood supply artery that can reach the lesion site of the foot from the origin of superficial femoral artery must be established.For multiple lesions of below-knee arteries,it is recommended to follow the principle of first reconstruction of the lesions that is easier to be re-canalized so as to ensure that at least one blood vessel can supply to the diseased foot.Besides,the 9th edition guidelines introduces the great application value of five-point method equipment used for treating diabetic foot disease at the Shanghai Tongji University of China.