小口径长球囊血管扩张术治疗糖尿病足  

Technique of minorcaliber and long balloon in treatment of lower limb peripheral arterial disease on diabetic patients

作　　者：娄尧强[1] 徐侃[1] 孟路阳[1] 王林君[1] 王晓栋[1] 王松茂[1] 金晔[1] 

机构地区：[1]杭州市第三人民医院血管外科,浙江省杭州310009

出　　处：《中国基层医药》2011年第2期169-171,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：基金项目：浙江省杭州市科技局项目（20080333814）

摘　　要：目的探讨小口径长球囊血管扩张术治疗治疗糖尿病足及膝下小动脉病变的疗效。方法回顾性分析16例（21条）采用膝下血管球囊扩张术治疗糖尿病足膝下血管狭窄闭塞性病变患者的临床资料。观察手术成功率、并发症、临床疗效和踝肱指数等。结果手术成功率90．5％（19／21），术中无严重并发症。患者术后临床症状明显改善，术后踝肱指数为（0．57±0．23），较术前（0．31±0．15）明显提高（P〈0．05）。静息痛者术盾疼痛消失9条（60．0％），明显缓解4条（26．7％），减轻2条（13．3％）。足坏疽者溃疡愈合4条（66．7％），溃疡面积明显缩小1条（16．7％），高位截肢1条（16．7％）。术后随访2条肢体因症状再次加重行二次球囊扩张术。结论小口径长球囊技术用于治疗糖尿病足膝下小动脉病变成功率高，并发症低，疗效确切，可降低患者的病残率。Objective To investigate the effect of percutaneous transluminal angioplasty（PTA） by minor-caliber and long balloon on diabetic patients with below-knee artery. Methods 16 consecutive DM patients（21 limbs） were treated with PTA by minor-caliber and long balloon and followed 7 months（ 1 - 22 months）. The success rate, complication,cllnical effects and the changes of ABI were investigated and analyzed. Results The technical success rate is 90.5% （ 19/21 ） ,no serious complication occurred. The clinical symptoms of all patients improved after successful PTA. The median ABI marginally increased from the baseline value of （0.31 ＋ 0.15 ） to （ 0.57- 0.23 ） after intervention,the difference is significant （P 〈 0. 05）. Post-operative pain in patients with rest pain disappeared 9 （60.0%）, relieved 4（26.7% ）, reduce 2 （13.3%）. Ulcer healing in patients with foot gangrene 4 （66.7%）, Ulcer area was significantly reduced 1 （ 16.7% ） , high amputation 1 （ 16.7% ）. Postoperative follow-up, two limbs reoperation because of increased symptoms. Conclusion The treatment of percutaneous transluminal angioplasty by minorcaliber and long balloon was effective on diabetic patients with below-knee arterial disease.

关 键 词：糖尿病足 血管成形术 

分 类 号：R65[医药卫生—外科学] R587[医药卫生—临床医学]