应用长球囊治疗糖尿病下肢血管病变的近期疗效观察  

Short term evaluation of the percutaneous transluminal angioplasty with long balloon for the treatment of the ischemic disease of lower extremity in diabetes

作　　者：秦汉林[1] 高斌[1] 

机构地区：[1]徐州医学院研究生学院,221002

出　　处：《安徽医学》2011年第3期346-349,共4页Anhui Medical Journal

基　　金：安徽省科技厅年度计划项目(项目编号:09020303043)

摘　　要：目的探讨应用小口径长球囊经皮腔内血管成形术（PTA）治疗糖尿病足患者下肢血管病变的近期临床价值。方法对25例患者36条糖尿病足下肢病变血管行数字减影血管造影（DSA）检查,并对狭窄处实施PTA。结果术后即刻16例22条患肢疼痛明显缓解。术后24 h,患肢皮温及踝肱指数（AB I）均较术前显著升高;术后跛行距离是持续改善的,而且改善均有统计学意义,术后1月随访较术后24 h、术后7 d数值改变更明显。长期不愈的溃疡于治疗后1-3个月逐渐愈合。1例由于感染不能控制于治疗后6周行截趾术,明显降低了截趾平面。结论经皮血管球囊成型术微创、安全、有效,对糖尿病足下肢缺血动脉介入治疗近期疗效满意。Objective To evaluate the recent clinical value about the treatment of the percutaneous transluminal angioplasty（PTA） with the long small-caliber balloon in patients with diabetic foot lower extremity vascular disease.Methods After anterograde or retrograde percutaneous puncture of femoral arteries,25 patients（36 lower extremities） with severe ischemia of lower extremities were examined with digital subtraction angiography（DSA）,then the stenosis of arteries were treated by PTA.Results 22 lower extremities in 16 cases of limb pain was relieved immediately after intervention.After 24h,the ankle-brachial index（ABI） and the skin temperature of the limb was significantly higher than that preoperatively;but the improvement of claudication distance was sustained,and showed significant improvement,compared with 24 and 7 days postoperative,the following-up values changed were more evidentafter 1 month.Unhealed ulcers were gradual healed in the long-term of 1 to 3 months postoperative.1 case whose toe ulcer infection could not control was cut-off 6 weeks postoperative,the cut-off flat reduced significantly.Conclusion PTA is a safe and effective method for treatment of the stenosis of arteries in diabetes,and is effective in promotion of the lower extremity arterial blood perfusion in short time.

关 键 词：糖尿病 下肢缺血 血管腔内成形术 

分 类 号：R587.2[医药卫生—内分泌]