下肢远端动脉旁路移植治疗糖尿病足46例报告

Surgical treatment for diabetic foot using distal arterial bypass grafting in lower limbs:a report of 46 cases

目的 探讨糖尿病足外科旁路移植的方法。方法 2 0 0 0～ 2 0 0 2年 4 6例 2型糖尿病病人 ,5 2条下肢接受了动脉旁路移植手术。主要方式为动脉 -小腿动脉旁路移植 16条 (30 8% )和股动脉 -动脉人工血管 -单支小腿动脉自体血管旁路移植术 15条 (2 8 9% ) ,其次为动脉 -单支小腿动脉 -足背动脉自体血管旁路移植术7条 (13 5 % )。结果 4 6例病人中 ,2例因术后呼吸功能衰竭死亡 ,手术成功率 95 7% ,救肢率 98 0 % ,出院时血管通畅率 10 0 % ,足部创面的愈合率 4 4 5 %。结论 糖尿病足作为糖尿病的一种严重并发症 ,是可以通过下肢远端动脉旁路移植而获得较好的疗效 ;不仅可以挽救肢体或降低截肢平面 ,而且可以为足部创面的愈合提供一个较好的营养环境。

Objective To investigate the effect of surgical treatment for diabetic foot using distal arterial bypass grafting in lower limbs. Methods All 46 cases suffering from type 2 diabetes mellitus with 52 affected lower limbs were performed arterial bypass grafting,mainly including:popliteal- tibial arterial bypass in 16 limbs (30.8%),femoral-popliteal and popliteal-tibial arterial bypass in 15 limbs (28.9%) and popliteal-tibial-pedal arterial bypass in 7 limbs (13.5%).Results Of 46 cases,2 (3 limbs) died of respiratory failure.The success rate was 95.7%.The rate of limb-saving,diabetic foot ulcer healing and successful bypass grafting on discharge was 98%,44.5% and 100%,respectively.Conclusion For diabetic foot good outcome can be expected by using distal arterial bypass grafting of lower limbs.It can not only avoid amputation or lower amputation level,but also improve blood circulation to promote foot healing.