老年2型糖尿病性下肢动脉病变的腔内治疗  

The endoluminal therapy for diabetic peripheral artery disease in elderly patients

作　　者：李黎[1] 庄舜玖[1] 戚韶红[1] 崔佳森[1] 周俊文[1] 张婉[1] 朱华琦[1] 赵云[1] 

机构地区：[1]复旦大学附属华东医院血管外科,上海市200052

出　　处：《老年医学与保健》2014年第2期87-89,共3页Geriatrics & Health Care

摘　　要：目的 观察并总结腔内治疗老年2型糖尿病严重下肢动脉病变的临床疗效及技术经验.方法 收集2010年2月-2012年2月55例老年2型糖尿病性下肢动脉疾病患者,采用INVATEC-DEEP长球囊,进行下肢动脉经皮穿刺血管腔内成形术（percutaneous transluminal angioplasty,PTA）治疗,观察治疗前后的临床症状、体征及踝肱指数（ankle brachial index,ABI）的改变,并进行随访.结果 55例患者共55条肢体接受了腔内治疗,技术成功率为74.5％（41/55）,无并发症发生.共随访6m,失访率为0;其中,技术成功组所有患肢血供明显增加,相应节段肢体皮温升高,足背动脉搏动增强,麻木感和痛感显著减轻,生存率为95.1％,肢体存活率97.6％;技术失败组患者生存率为78.6％,肢体存活率71.4％,随访期间ABI为（0.78±0.13）.结论 腔内治疗老年2型糖尿病性下肢动脉疾病技术成功率高,临床疗效显著,但远期效果有待进一步随访.Objective To evaluate the clinical effects and summarize the technical experience of endovascular therapy on diabetic peripheral artery disease in elderly patients. Methods From February 2010 to February 2012, 55 consecutive elderly diabetic patients coexisted with severe peripheral vascular lesion were enrolled. Percutaneous transluminal angiop- lasty （PTA） using long INVATEC-DEEP balloons was applicated. The symptoms, signs and ABI were observed before and after the treatment. All the patients were followed up. Results In all the 55 patients （55 limbs）, the technical success rate was 74.5%, without any complications. All cases were followed up to 6 months. In the group of technical success, the blood supply increased, skin temperature raised, pulsations of dorsal artery strengthened, and the numbness and pain decreased significantly. The survival rate in technically success group was 95. 1%, with a limb rescue rate of 97.6%. Mean- while, The survival rate of the technical failed group was 78.6%, with a limb rescue rate of 71.4%, ABI was elecated to （0.78 ±0.13 ）. Conclusion Endoluminal therapy is a feasible technique for diabetic peripheral artery disease in elderly pa- tients. It has a significant clinical effects. But the long-term outcomes still need more follow-up.

关 键 词：糖尿病足 糖尿病血管病变 动脉造影术 

分 类 号：R587.2[医药卫生—内分泌]