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糖尿病下肢血管病变介入治疗的疗效观察
【摘要】目的 评价糖尿病下肢血管病变的介入治疗临床效果。方法 对术前经保守治疗无效的糖尿病下肢血管病变患者18例行介入治疗。其中41支病变血管行血管内球囊扩张, 15支血管行腔内支架植入术。术后常规抗凝治疗1周。结果 介入治疗后患者的临床症状、体征均明显缓解，踝肱指数明显提高,差异有统计学意义(P＜0.05或＜0.01)。结论 糖尿病下肢血管病变的血管内介入治疗安全、有效,具有推广应用价值。
【关键词】 糖尿病下肢血管病变 介入治疗
Therapeutic effect of interventional treatment on diabetic patients with vascular lesions in lower limbs QI Huiqing,TIAN Huiyu, WANG Fujun. Department of Endocrinology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011,China
【Abstract】 Objective To assess the therapeutic effect on diabetic patients with vascular lesions in lower limbs.Methods Eighteen diabetic patients with chronic incurable vascular lesions in lower limbs were treated by interventional treatment. Among them fortyone vessels with irregular stenosis and obstruction were treated by intravascular angioplasty through balloon dilation and fifteen vessels were treated by intravascular stenting. Regular anticoagulant therapy was given for 1 week after interventional treatment.Results The patients’ symptoms and physical signs were obviously relieved and ABI raised obviously after interventional treatment. There was a significant difference in symptoms,physical signs and ABI of patients between pretherapy and posttherapy.Conclusion Intravascular interventional treatment is safe, effective and valuable for diabetic patients with vascular lesions in lower limbs.
【Key words】 diabetes with vascular lesions in lower limbs; interventional treatment
WHO将糖尿病足(diabetic foot,DF)定义为糖尿病(diabetes mellitus,DM)患者发生的与下肢远端神经异常和不同程度的周围血管病变相关的足部感染、溃疡和(或)深层组织破坏［1］。DF常常是下肢血管病变、神经病变和感染共同作用的结果,严重者常需截肢甚致死亡。其传统治疗方法包括控制血糖、抗炎、改善循环、营养神经、局部减压、局部换药等综合对症治疗,但治疗效果常不理想，发生溃疡者愈合缓慢。经保守治疗无效的糖尿病下肢血管病变患者采用介入治疗改善下肢血供，观察其疗效，报告如下。
1 资料与方法医学全.在.线www.lindalemus.com
1.1 一般资料 收集2007年6月至2008年8月我科住院的糖尿病性下肢血管病变患者18例,其中男9例,女9例；年龄47～84岁，平均年龄(71±12)岁；糖尿病病程3～15年。其临床表现均有患肢明显缺血症状：如冷感、间歇性跛行、缺血性静息痛等症状中的一种或几种；体征有下肢动脉搏动减弱或消失、皮温低, 甚至足部溃疡、坏疽等。术前均经多种传统治疗方法综合治疗4周以上且疗效不佳。
