Angiosome指导下糖尿病足血管腔内治疗的近期临床疗效  

Short-term clinical outcome of endovascular treatment based on Angiosome concept in patients with diabetic foot

作　　者：张光军[1] 周文华[1] 施慧华[2] 杨治[1] 张海清[1] 姚凯[1] 单远洲[1] 张学利[1] 

机构地区：[1]上海交通大学附属第六人民医院南院普外科,上海201400 [2]上海交通大学医学院附属第九人民医院血管外科

出　　处：《上海医学》2014年第11期923-926,I0001,共5页Shanghai Medical Journal

摘　　要：目的评价Angiosome指导下糖尿病足(DF)血管腔内治疗的近期临床疗效和安全性。方法 2013年1—12月间共有30例缺血性DF患者(34条患肢)按照Angiosome概念评价足部破损区域的目标血管并行血管腔内治疗,观察技术成功率和并发症发生率;在术后1周和1、3、6个月,分析患者的临床症状、踝肱指数(ABI)和血管通畅率。结果成功开通目标血管患肢28条,技术成功率为82.4%(28/34)。围术期7例患者(23.3%)发生并发症。30例患者均获随访。术后1周患肢静息痛发生率,以及术后1周和1个月患肢皮温低、皮色苍白、无足背动脉搏动的发生率均较术前显著降低(P值均<0.05)。术后1周和1个月患者的跛行距离均显著长于术前(P值均<0.05)。术后1周和1、3、6个月,患者的ABI分别为0.87±0.26、0.84±0.19、0.81±0.22和0.72±0.35,均显著高于术前的0.24±0.28(P值均<0.01)。术后3和6个月的血管通畅率分别为85.7%(24/28)和75.0%(21/28)。结论 Angiosome指导下DF血管腔内治疗是可行、安全、有效的,但其长期疗效有待进一步观察。Objective To evaluate the safety and efficacy of endovascular treatment based on Angiosome concept for diabetic foot. Methods Thirty patients （34 limbs） with diabetic foot underwent endovascular treatment based on Angiosome concept between January 2013 and December 2013. Technical success rate and complication incidence were evaluated. Clinical symptoms, ankle-brachial index （ABI） and patency rate were recorded on week 1, and month 1, 3 and 6 after operation. Results The initial technical success rate was 82.4% （28/34）, and perioperative complication incidence was 23.3% （7/30）. All 30 patients were followed up. The incidence of limb rest pain at 1 week after operation and the incidence of lower limb skin temperature, pallor, no pulsation of the dorsalis pedis artery at 1 week and 1 month after operation were significantly lower than those before treatment （all P〈0.05）. The claudication distance at 1 week and 1 month after operation were significantly longer than those precperation （all P〈0.05）. The average ABI was 0.87 ± 0.26, 0.84 ± 0.19, 0.81 ±0.22 and 0.72±0.35 at 1 week, 1, 3 and 6 months after operation, respectively, which were significantly higher than preoperative ABI （0.24±0.28, all P〈0.01）. Patency rate of vessel was 85.7% （24/28） and 75.0% （21/28） at 3 and 6 months after operation, respectively. Conclusion Endovascular treatment based on Angiosome concept is a feasible, safe and effective procedure for diabetic foot. But the long term outcome needs to be observed in the future.

关 键 词：Angiosome概念 糖尿病足 腔内治疗 

分 类 号：R587.2[医药卫生—内分泌]