腓骨横向骨搬移术治疗重度糖尿病足的疗效观察  

Efficacy of tibial transverse transport in the treatment of severe diabetic foot

作　　者：张博凯 陈炎 林震迅 高伟[1] 何立环 邝晓聪[3] 花奇凯[1,2] Zhang Bokai;Chen Yan;Lin Zhenxun;Gao Wei;He Lihuan;Kuan Xiaocong;Hua Qikai(Department of Bone and Joint Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Coconstructed by the Province and Ministry,Guangxi Medical University,Nanning 530021,China;School of Basic Medical Sciences,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院骨关节外科,南宁530021 [2]广西医科大学再生医学与医用生物资源开发应用省部共建协同创新中心,南宁530021 [3]广西医科大学基础医学院病理生理教研室,南宁530021

出　　处：《广西医科大学学报》2022年第5期826-832,共7页Journal of Guangxi Medical University

基　　金：国家自然科学基金资助项目(No.8206090115,No.81601930);广西自然科学基金资助项目(No.2017GXNSFAA198318,No.2016GXNSFBA380007,No.2017GXNSFAA198293);广西医科大学第一附属医院临床研究攀登计划资助项目(No.YYZS2020010)。

摘　　要：目的:探讨腓骨横向骨搬移术治疗重度糖尿病足的疗效和安全性,并与胫骨横向骨搬移术治疗重度糖尿病足对比。方法:回顾性分析2016年8月至2021年10月接受治疗的重度糖尿病足患者30例,将患者按随机数字表法分为腓骨横向骨搬移组、胫骨横向骨搬移组和传统治疗组3组,每组10例,术后观察患者足部溃疡愈合情况,评估住院时间、疼痛评分症状等,并计算愈合率、保肢率、复发率等情况。结果:所有患者均获得随访,随访时间5~48个月,平均(19.1±2.3)个月。腓骨横向骨搬移组患者患足9例愈合,愈合率90.0%,创面平均愈合时间(15.4±4.3)周,全部保肢,保肢率100%;且患者治疗后的疼痛、麻木症状均得到显著改善。至末次随访时,所有已愈合的溃疡均未复发。腓骨横向骨搬移组、胫骨横向骨搬移组溃疡复发率和患者截肢率均优于传统治疗组(均P<0.05)。结论:腓骨横向骨搬移术对糖尿病足有较好的临床疗效,能加速创面愈合,有效降低患者糖尿病足坏死截肢率。Objective:To investigate the efficacy and safety of fibula transverse transport in the treatment of severe diabetic foot(DF),and compared with tibial transverse transport(TTT)in the treatment of severe DF.Methods:Thirty patients with severe DF treated from August 2016 to October 2021 were retrospectively analyzed.The patients were randomly divided into fibula transverse transport,TTT group and traditional treatment group(n=10 per group).After operation,the healing of foot ulcer was observed.The hospital days and pain score were evaluated,and the healing rate,limb salvage rate and recurrence rate were calculated.Results:All patients were followed up for 5 to 48 months,with the average of(19.1±2.3)months.In the fibula transverse transport group,9 patients with foot healed,the healing rate was 90.0%,the average wound healing time was(15.4±4.3)weeks,all limb salvage,limb salvage rate was 100%,and the pain and numbness symptoms were significantly improved after treatment.At the last follow-up,all the healed ulcers did not recur.The ulcer recurrence rate and amputation rate in the fibula transverse transport group and TTT group were better than those in the traditional treatment group(P<0.05).Conclusion:Fibula transverse transport has a good clinical effect on DF,which can promote wound healing and effectively reduce the amputation rate of diabetic foot necrosis.

关 键 词：ILIZAROV技术 腓骨 骨搬移 糖尿病足 

分 类 号：R587.2[医药卫生—内分泌]