胫骨横向骨搬移手术对糖尿病足患者患肢血流动力学状态、血管血运情况及运动功能的影响  

Effect of transverse tibial bone transfer surgery on hemodynamic status,vascular blood circulation and motor function of diabetic foot patients

作　　者：吴志昌 蒋桂勇[2] 莫捷华 WU Zhichang;JIANG Guiyong;MO Jiehua(Department of Orthopaedics,Zengcheng Xintang Hospital,Guangdong Province,Guangzhou511340,China;Department of Orthopedics for Trauma,Nanfang Hospital,Southern Medical University,Guangdong Province,Guangzhou 510515,China)

机构地区：[1]广州市增城区新塘医院骨科,广东广州511340 [2]南方医科大学南方医院创伤骨科,广东广州510515

出　　处：《中国当代医药》2023年第17期87-91,共5页China Modern Medicine

基　　金：广东省中医药局科研项目(20201283)。

摘　　要：目的分析胫骨横向骨搬移手术治疗糖尿病足的价值。方法回顾性选取2017年3月至2021年10月广州市增城区新塘医院及南方医科大学南方医院收治的74例重度(3~4级)糖尿病足患者作为研究对象,按照治疗方式分为研究组(胫骨横向骨搬移手术,n=40)与传统组(传统清创负压引流术,n=34),记录两组患者双侧动脉血流动力学指标,比较两组患者运动神经传导速度(MCV)与感觉神经传导速度(SCV)、运动神经潜伏期(LAT)。结果术后3个月,研究组患侧股总动脉、腘动脉、胫后动脉、足背动脉患侧血流量高于传统组,血管阻力指数低于传统组,胫神经、腓神经MCV、SCV高于传统组,LAT低于传统组,差异有统计学意义(P<0.05)。结论胫骨横向骨搬移术较传统清创负压引流更能改善糖尿病足患肢血流动力学,重建患肢血运,更利于患肢运动功能恢复。Objective To analyze the value of transverse tibial bone transfer surgery in the treatment of diabetic foot.Methods Seventy-four patients with severe(grade 3-4)diabetic foot admitted to Zengcheng Xintang Hospital and Nanfang Hospital,Southern Medical University from March 2017 to October 2021 were retrospectively selected as research objects,and they were divided into the study group(transverse tibial bone transfer surgery,n=40)and the traditional group(traditional debridement and negative pressure drainage,n=34)according to treatment methods.Bilateral arterial hemodynamics of the two groups were recorded.Motor conduction velocity(MCV),sensory nerve conduction velocity(SCV)and motor latency(LAT)were compared between the two groups.Results Three months after surgery,the blood flow of the affected side of the common femoral artery,popliteal artery,posterior tibial artery and dorsal foot artery in the study group were higher than those of the traditional group,the vascular resistance index was lower than that of the traditional group,the tibial nerve,peroneal nerve MCV and SCV were higher than those of the traditional group,the LAT was lower than the traditional group,the differences were statistically significant(P<0.05).Conclusion Compared with traditional debridement and negative pressure drainage,transverse tibia bone transfer surgery can improve the hemodynamics of diabetic foot,rebuild the blood supply of diabetic foot,and facilitate the recovery of motor function of diabetic foot.

关 键 词：糖尿病足 重度 胫骨横向骨搬移手术 血流动力学 运动传导 

分 类 号：R587.2[医药卫生—内分泌]