摘要
目的分析CT血管成像（CTA）在临床糖尿病足治疗中的应用价值，以提高糖尿病足的治疗水平，降低致残率及二次手术率。方法自2000年10月至2013年1月，对50例糖尿病足患者均予综合治疗：严格控制血糖，早期全身应用扩血管、改善微循环、抗血小板凝集药物及抗生素，局部清创换药，并行CTA评估下肢动脉阻塞情况，根据病情综合应用包含局部清创、换药、封闭负压吸引（VSD）、植皮、截趾截肢等多种治疗方式。结果本组50例患者经综合治疗后，局部清创换药、植皮愈合5例，局部清创换药、VSD术、植皮愈合20例，截趾术12例，小腿截肢10例，大腿截肢3例。所有病例均未因肢体残端再次坏死而行二次手术。结论糖尿病足患者病情多样，应充分利用CTA评估病情，对于存在明确阻塞部位的，应在传统治疗的基础上试行介入治疗。即使肢体坏死无法保留，CTA检查亦可协助选择合理的截除平面。
Objective To analysis the value of CT angiography （CTA） in diabetic foot treatment aimed to improve the treatment level and decrease the rate of secondary operation and disability. Methods From October 2030 to January 2013, 50 clinical cases with diabetic foot underwent the comprehensive treatment of strictly glycemic control, vasodilation and microcirculation improving treatments, antiplatelet drugs and antibiotic, local wound debridement and dressing change, evaluating the lower extremity arteries stenosis with CTA. Comprehensive treat- ment was conducted according to patient＇s condition. Results After the treatment, 5 cases healed with debride- ment, dressing change, skin grafting. 20 cases healed with debridement, dressing change, vacuum sealing drain- age （VSD）, skin grafting. 12 cases got toe amputation, while 10 cases with calf amputation, and 3 cases with thigh amputation. No cases received a secondary operation due to poor healing. Conclusion The diabetic foot patient＇s condition were complicated, and CTA should be used to evaluating the lower extremity arteries stenosis. If the stenosis was confirmed, on the base of the traditional treatment, interventional therapy should be performed to improve microcirculation. Even if the foot gangrene occur, CTA could help to decide the level of amputation.
出处
《中国美容整形外科杂志》
CAS
2013年第10期593-595,共3页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
糖尿病足
CT血管成像
封闭负压引流
Diabetic foot
Computed tomographic angiography
Vacuum sealing drainage
