【摘要】 目的研究糖尿病膝下血管病变伴重症肢体缺血的腔内治疗的近、远期疗效。方法 2006年3月至2010年12月应用腔内血管成形术治疗糖尿病膝下血管病变伴重症肢体缺血63例,所有患者均有糖尿病病史,平均年龄73.2岁,男性49例,女性14例。临床症状分级(Rutherford分级标准):Ⅳ级47例(74.6%),Ⅴ级16例(25.4%)。术前患肢踝肱指数(ABI)为0.31±0.17。全部63例病变均累及膝下血管,其中膝下血管单支病变9例(14.3%),复合病变(2支或以上者)54例(85.7%);合并髂股动脉病变43例(68.3%)。结果手术成功率为92.1%(58/63),术后58例患者症状得到不同程度改善,无死亡病例。手术并发症率为7%(5/63),术后ABI平均为0.65±0.23。随访1年的通畅率为53.1%。结论腔内血管成形术治疗糖尿病性膝下血管病变伴重症肢体缺血安全有效,且并发症少,死亡率低,可重复应用,但远期通畅率有待提高。更多还原

【Abstract】 Objective To investigate the short-term and long-term effect of percutaneous transluminal angioplasty in treating infrapopliteal artery disease associated with critical limb ischemia in diabetic patients.Methods Between March 2006 and December 2010 at the hospital,a total of 63 diabetic patients with infrapopliteal artery disease and critical limb ischemia underwent percutaneous transluminal angioplasty.The patients included 49 males and 14 females with an average age of(73 ± 6.2) years.According to Rutherford classification,47 cases(74.6%) belonged to grade Ⅳ and 16 cases(25.4%)belonged to grade Ⅴ.Vascular ultrasonography,MRA and angiography of lower extremity were performed in all 63 patients.The ABI of the affected lower extremity was measured.The preoperative mean ABI was 0.31 ±0.17.The below-knee arteries were involved in all patients,including single branch lesion(a = 9,14.3%)and complex lesion that affected ≥ 2 branches(n = 54,85.7%).Iliofemoral artery was involved in 43 cases(68.3%).Results The technical success rate was 92.1%(58/63).After the treatment the clinical symptoms were improved in different degrees in 58 patients.No death occurred.The incidence of complications was 7%(5/63).The postoperative mean ABI was 0.65 ± 0.23.One year after the treatment the patency rate of the artery was 53.1%.Conclusion For the treatment of infrapopliteal artery disease associated with critical limb ischemia in diabetic patients,percutaneous transluminal angioplasty is safe and effective with fewer complications and lower mortality,and the procedure can be repeatedly used,although the long-term patencyrate needs to be improved.更多还原