经皮腔内血管成形术治疗糖尿病膝下动脉病变.docVIP

经皮腔内血管成形术治疗糖尿病膝下动脉病变 成 军，赵 渝，张 矛 (400016 重庆，重庆医科大学附属第一医院血管外科) [摘要] 目的 探讨分析糖尿病膝下动脉狭窄及闭塞病变的特点及腔内治疗方法，总结技术要点，观察经皮腔内血管成形术（PTA）治疗的临床疗效。方法 回顾性研究2008年5月至2011年5月本科收治的糖尿病合并缺血性下肢动脉病变患者67例，共124条动脉施行了PTA。观察技术成功率、疗效及并发症。 结果 67例患者共124条动脉分别行PTA，术后ABI明显提高（P＜0.05），患者症状改善。8例行踝关节上截肢术，保肢率90.1%。本组病例技术成功率88.8%。术后随访52例，平均15.6(6～36)个月，6个月通畅率82.4%，12个月通畅率69.1%。无严重并发症发生。结论 PTA是治疗糖尿病膝下动脉狭窄和闭塞性病变的安全、有效和微创的方法。 [关键词] 糖尿病；经皮腔内血管成形术；球囊 [中图法分类号] R815; R587;R543.5 [文献标志码] A Treatment of lower extremity artery disease in diabetic patients with percutaneous transluminal angioplasty Cheng Jun, Zhao Yu, Zhang Mao (Department of Vascular Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China) [Abstract] Objective To study the characteristics of lower extremity artery stenosis or occlusion in diabetic patients and the effect of percutaneous transluminal angioplasty (PTA) on it. Methods Sixty-seven diabetic patients with ischemic lower extremity disease involving 124 arteries who underwent PTA from May 2008 to May 2011 in our department were retrospectively analyzed. The success rate, therapeutic effect and complications of PTA were observed. Results The ABI was significantly higher in 67 diabetic patients with ischemic lower extremity disease involving 124 arteries after PTA than before PTA (P0.05). The symptoms of the patients improved. Eight patients underwent amputation above the ankle with an extremity preservation rate of 90.1% and a success operative rate of 88.8%. Fifty-two patients were followed up for 15.6 months (range 6-36 months) with a 6-month patency of 82.4% and a 12-month patency of 69.1%. No severe complications occurred. Conclusion PTA is a safe, effective and minimally invasive procedure for stenosis or occlusion of lower extremity arteries [Key words] percutaneous transluminal angioplasty；diabetes；balloon 缺通信作者及联系方式？ 糖尿病血管病变广泛累及膝下多支血管，是糖尿病足形成的三大原因之一[1-2]，血运重建难度较大，截肢的风险较高，预后差。2008年5月至2011年5月本科对67例糖尿病膝下血管病变患者进行了经皮腔内血管