腓骨横向骨搬移技术治疗糖尿病足溃疡疗效观察  

Observation on the curative effect of fibula transverse transport technique in the treatment of diabetic foot ulcer

作　　者：喻姿瑞 宋涛[1] 张文韬 从飞 田小宁 范金柱 刘亚飞 Yu Zirui;Song Tao;Zhang Wentao;Cong Fei;Tian Xiaoning;Fan Jinzhu;Liu Yafei(Department of Bone Microsurgery,Hong Hui Hospital,Xi′an Jiaotong University,Xi′an 710054,China)

机构地区：[1]西安交通大学附属红会医院骨显微修复外科,西安710054

出　　处：《中华医学杂志》2021年第39期3248-3252,共5页National Medical Journal of China

摘　　要：探讨应用腓骨横向骨搬移技术治疗糖尿病足溃疡的临床疗效。2017年9月至2020年9月应用腓骨横向骨搬移技术治疗糖尿病足溃疡患者9例,男7例,女2例,年龄43~66(55±9)岁,Wagner分级:2级2例、3级5例、4级2例,均为缺血性溃疡或缺血-神经性溃疡,检测患肢足背经皮氧分压(TcPO_(2)),并随访记录溃疡愈合及TcPO_(2)变化情况。9例均获得随访,随访时间3~38(23±12)个月,患足溃疡均愈合,愈合时间2~8(4.2±1.9)个月,均获得保肢,未出现皮肤坏死、针道感染等严重并发症,术前患足TcPO_(2)为(28.6±3.8)mmHg(1 mmHg=0.133 kPa),术后3个月为(35.0±5.6)mmHg,差异有统计学意义(P<0.05)。结果发现腓骨横向骨搬移技术可有效改善糖尿病足微循环功能,促进溃疡愈合,且操作简便、并发症少。To investigate the clinical effect of fibula transverse transport technique in the treatment of diabetic foot ulcer.Nine patients(7 males and 2 females)with diabetic foot ulcer were treated with fibula transverse transport technique from September 2017 to September 2020.The mean age was(55±9)years(ranged from 43 to 66 years).In terms of Wagner classification,2 cases were in grade 2,5 cases were in grade 3,and the other 2 cases were in grade 4.All of the cases involved ischemic ulcers or ischemic-nerve ulcers.The transcutaneous oxygen pressure(TcPO_(2))of the dorsal foot of the affected limb was measured,with the ulcer healing and TcPO_(2) changes recorded at follow-up.All the 9 patients were followed up for(23±12)months(3 to 38 months).It was found that all patients with foot ulcers were cured within(4.2±1.9)months(2 to 8 months),and all the patients obtained limb salvage.Besides,there was no serious complications occurred,such as skin necrosis and needle tract infection.Before the operation,the TcPO_(2) of the affected foot was(28.6±3.8)mmHg(1 mmHg=0.133 kPa),while it was(35.0±5.6)mmHg three months after operation(P<0.05).The technique of fibula transverse transport can effectively improve the microcirculation function of diabetic foot,and it can promote the healing of the ulcer with few complications.

关 键 词：腓骨 横向骨搬移 糖尿病足 溃疡 疗效 

分 类 号：R687.3[医药卫生—骨科学] R587.2[医药卫生—外科学]