基于Angiosome理念的腔内治疗干预糖尿病足的临床研究

目的:探讨Angiosome理念指导下的腔内治疗干预糖尿病足(DF)的效果。方法:选取滨州市沾化区人民医院、济南市中医医院和山东省立医院2015年1月—2018年1月收治的DF患者47例,随机分为Angiosome组和PTA组。Angiosome组患者基于Angiosome理念开展腔内治疗,PTA组患者常规开展PTA治疗。观察两组患者治疗前后踝肱压力指数(ABI)、疼痛视觉模拟评分(VAS)和随访期内截肢情况。结果:两组患者治疗后ABI和VAS评分较治疗前显著改善,Angiosome组患者ABI和VAS改善情况优于PTA组患者,随访期内截肢率低于PTA组。结论:基于Angiosome理念的腔内治疗可以显著改善DF患肢的缺血状态,有效降低截肢率。     

Reproducibility of radiographic methods for assessing longitudinal tarsal axes Part 2: Severe cavus or flatfoot study

IntroductionCalcaneal pitch angle and Meary’s angle are commonly used to assess longitudinal foot arches on lateral-view radiographs. The aim of this study was to examine and evaluate the radiographic longitudinal foot arch measurement methods with the best intraobserver and interobserver reliabilities for patients with (1) severe cavus deformity and (2) severe flatfoot deformity.MethodsStanding radiographic images of 22 feet with severe cavus foot deformity and 49 feet with severe flatfoot deformity were obtained to measure the longitudinal axes of the talus, first metatarsal, calcaneus and plantar surface, which were defined using six, five, four and three different methods, respectively, selected from previous reports. Intraobserver and interobserver correlation coefficients were calculated.ResultsThe results are generally consistent with those of Part 1. The best intraobserver and interobserver correlation coefficients for the tarsal axes were obtained using methods involving a line bisecting the angle formed by the lines tangential to the superior and inferior margins of the talus, a line connecting the centre of the first metatarsal head and the midpoint of the visualized base of the first metatarsal, and a line drawn tangential to the inferior surface of the calcaneus. For the plantar axis, a method that used the horizontal plane (as a reference axis) was regarded as the best approach.ConclusionsThe aforementioned methods were considered to be optimal for the radiographic assessment of longitudinal foot arches in patients with severe cavus or flatfoot deformity. This study may contribute to the more accurate assessment of any foot deformity.     

凡士林纱布覆盖修复足背部皮肤缺损

目的：探讨凡士林纱布覆盖修复足背部皮肤缺损的疗效。方法选取2010年3月~2012年3月我院收治的16例足背部皮肤缺损患者，清创后均给予凡士林纱布覆盖治疗，术后观察创面愈合程度、感染情况及皮肤感觉恢复情况。结果术后随访18个月，均达愈合标准，术后伤口感染1例，术后1年感觉基本恢复。结论凡士林纱布覆盖修复足背部皮肤缺损疗效确切，方法简单，安全，经济实惠。