早期筛查和干预糖尿病下肢动脉病变预防糖尿病足  

Early Screening and Interfering Diabetic Lower Limb Peripheral Arterial Disease to Prevent Diabetic Foot Disease

作　　者：黄院英[1] 杨玉生[2] 

机构地区：[1]无锡市人民医院内分泌科,无锡214023 [2]无锡市第二人民医院骨科,无锡214002

出　　处：《中国医药导刊》2013年第7期1152-1153,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨糖尿病下肢外周动脉病(PAD)的早期筛查和干预方法,观察预防糖尿病足的效果。方法:选取本院住院的1320名糖尿病患者,用踝肱指数(ABI)、趾肱指数(TBI)来筛选PAD。PAD者,除常规进行糖尿病血糖控制外,住院期间给予复方丹参液和前列地尔液治疗,出院后长期口服复方丹参片。门诊随访:每三个月测定ABI一次。结果:1320名糖尿病患者中PAD阳性326例,经B超证实者321例,其中0.5≤ABI<0.9者278例,0.3≤ABI<0.5者41例,ABI<0.3者2例。321例患者全部得到随访,随访时间2～3年,平均1.8年,PAD由阳性转为阴性者19例,ABI上升0.2及以上者51例,ABI无变化者239例,总有效率95.3%。ABI下降0.2及以上者15例,出现糖尿病足病3例。结论:ABI配合TBI的筛查方法,具有检查无创性、价格低廉、使用方便的特点。Objective： To investigate the methods by Early screening and interfering diabetic lower limb peripheral arterial disease（PAD） in order to observe the result of preventing diabetic foot disease.Methods：1320 cases of hospitalize diabetic were selected to screen PAD by ankle-brachial index（ABI） and teo-brachial index（TBI）.Intervention ways：the positive PAD were tested by B ultrasonic in order to be make a definite diagnosis and were treated by complex Danshen injection and Alprostadil injection besides routine blood sugar controlling during the hospitalized time.The complex Danshen pill should be taken orally Post-discharge.Clinic service follow-up： test the ABI once per 3 months.Results： 326 cases is PAD positive of 1320 diabetes mellitus.321 cases were confirmed by B ultrasonic.278 cases ABI were between 0.5 to 0.9,41 cases ABI were between 0.3 to 0.4,2 cases ABI were below 0.3;321 cases were followed-up for 2 to 3 years,19 cases turned from positive to negative,51 cases ABI went up in 0.2 and more,239 cases ABI hadn’t changed.total effective rate was 95.3%;15 cases ABI had descened for 0.2 and more;3 cases caught diabetic foot disease.Conclusions： The screening methods by ABI and TBI has such characteristics as no wound,cost low and use conveniently.

关 键 词：糖尿病 周围动脉病 糖尿病足 筛查 干预 

分 类 号：R587.2[医药卫生—内分泌]