彩超在糖尿病足患者下肢动脉病变中的应用

目的分析探讨彩超在糖尿病足患者下肢动脉病变中的应用价值,为患者的临床治疗提供可供参考的依据。方法选择该院收治的糖尿病足患者100例作为研究对象,按照Wagner分级将这100例患者分成坏疽组和非坏疽组,坏疽组49例,非坏疽组51例,两组患者均进行多普勒彩超检查,并对其临床资料进行回顾性的分析,总结其病变特点。结果 1非坏疽组患者的下肢动脉闭塞率为0.00%,远远低于坏疽组的46.94%(P0.05);2坏疽组的各下肢动脉病变内径均小于非坏疽组(P0.05);3坏疽组的腓总神经运动神经潜伏期、波幅、传导速度异常率均高于非坏疽组(P0.05)。结论彩超在糖尿病足患者下肢动脉病变中具有积极的诊断价值,可以有效监测糖尿病足病变严重程度,为患者接下来的临床治疗提供准确的参考依据,值得在临床实践中应用推广。     

下肢动脉病变与糖尿病足的关系分析

将588例T2DM合并下肢动脉病变患者分为2组:糖尿病足组204例,非糖尿病足组384例。应用彩色多普勒分析患者下肢动脉病变的特点。结果:下肢动脉病变与糖尿病足的发生关系密切,糖尿病足合并下肢动脉病变患者的下肢动脉血管内径变窄、血流缓慢。结论:对T2DM患者应常规检查下肢动脉彩色多普勒,可早期发现血管病变及早期治疗以有效预防糖尿病足的发生和发展。     

应用彩色多普勒超声对糖尿病足病人下肢动脉血管病变的研究

目的观察糖尿病足（DF）病人下肢动脉形态学和血流动力学的改变。方法正常受试者（NS）25例，糖尿病（DM）病人26例，非肢端坏疽糖尿病足病人（NGDF）30例和肢端坏疽糖尿病足（GDF）病人26例。应用Acusonl28xP／10彩色电脑声像仪，线阵探头，频率7．0MHz，观察下肢动脉管径和血流的变化。结果DF两组病人下肢动脉血管病变，主要从胴动脉部位开始动脉硬化，尤其以胫后和足背动脉最为显著，动脉狭窄和闭塞是肢端缺血、坏疽的主要病因。观察发现，DM病人已有下肢胭动脉血流速度增高的血流动力学改变，GDF组病人胫后和足背动脉血流速度明显低于其他各组。结论彩色多普勒超声检测能帮助临床对糖尿病足下肢血管病变严重程度的判断、糖尿病足的诊断和治疗方案的制定有实用价值。     

彩色多普勒超声对2型糖尿病患者下肢动脉病变的诊断价值

目的探讨彩色多普勒超声对2型糖尿病患者下肢动脉病变的诊断价值。方法选择62例2型糖尿病患者作为观察组,75例非糖尿病患者作为对照组,用彩色多普勒超声技术探查并比较两组双下肢股总动脉、股浅动脉、股深动脉、腘动脉、胫前动脉、胫后动脉、足背动脉斑块、狭窄、闭塞的检出情况。结果观察组下肢动脉管腔硬化斑块、狭窄闭塞的发生率明显高于对照组,膝关节以下动脉的狭窄、闭塞检出率也明显高于对照组,两组比较差异具有统计学意义(P0.01)。结论糖尿病对下肢动脉尤其膝关节以下动脉病变有非常明显的影响,彩色多普勒超声作为无创、简单有效的检查方法,对早期诊断、病程观察、预防下肢坏疽在临床中起到非常重要的作用。     

糖尿病足与下肢闭塞性动脉硬化的相关性研究

本研究分析了188例2型糖尿病患者下肢闭塞性动脉硬化(ASO)与糖尿病足发病的关系,并应用彩色多普勒方法分析了糖尿病足患者下肢动脉的病变特点。发现ASO与糖尿病足的发生密切相关,且糖尿病足合并ASO者的下肢动脉血管内径缩窄、管壁增厚、血流缓慢。     

探讨彩色多普勒超声诊断糖尿病下肢血管病变的应用价值

目的探讨并分析彩色多普勒超声在糖尿病下肢血管病变患者中的诊断价值。方法 2018年1月—2019年1月间抽取糖尿病下肢血管病变患者20例作为观察组,再抽取20名同期于该院进行体检的健康人作为对照组,两组均采取彩色多普勒超声检查,观察两组研究对象的下肢血管病变情况、下肢血管斑块形成率以及下肢动脉血管内径比较。结果观察组患者下肢动脉血管内膜增厚、血管闭塞等情况的发生率显著高于对照组;观察组的下肢血管斑块形成率是60.00%,对照组是5.00%且观察组动脉管径显著低于对照组(χ~2=13.789,P0.05)。结论彩色多普勒超声在糖尿病下肢血管病变患者中的诊断价值显著,值得推广。     

彩超在糖尿病足患者下肢动脉病变中的应用

目的分析彩超在糖尿病足患者下肢动脉病变中的应用。方法择该院2016年10月—2017年2月收治90例糖尿病足病患资料,分研究组(50例),对照组(40例);研究组为非坏疽,对照组为坏疽,两组皆接受多普勒的彩超检测,观察两组的病变特点。结果足背动脉左肢研究组病变内经是(2.48±0.21)mm比对照组(1.50±0.31)mm大(P0.05);波幅的异常率研究组为80.00%(40/50)比对照组100.00%(40/40)低(P0.05);下肢动脉的闭塞率对照组为47.50%(19/40)比研究组0.00%(0/50)高(P0.05)。结论彩超应用于糖尿病足患者下肢运动脉病变中,诊断价值高。     

彩色多普勒血流显像诊断糖尿病下肢动脉病变的价值研究

目的研究彩色多普勒血流显像诊断糖尿病下肢动脉病变的价值。方法随机抽取该院自2015年2月—2016年4月收治的糖尿病下肢动脉病变患者50例,将其设为实验组,另随机选取该院非糖尿病下肢动脉病变的正常患者50例作为对照组。对100例患者均进行彩色多普勒血流显像诊断。而后对比两组患者的肢斑块、狭窄及闭塞检出率以及下肢动脉内径、血流速度。结果实验组的下肢斑块、狭窄及闭塞检出率(84%、32%、26%)均明显高于对照组的下肢斑块、狭窄及闭塞检出率(16%、8%、0%),差异有统计学意义(P0.05);实验组的下肢动脉内径明显小于对照组的下肢动脉内径,差异有统计学意义(P0.05);实验组的下肢动脉血流速度明显慢于对照组的下肢动脉血流速度,差异有统计学意义(P0.05)。结论彩色多普勒血流显像对糖尿病下肢动脉病变的诊断具有重要价值,对于患者病情的评估、判定及临床治疗方案的制定提供了依据。     

糖尿病足病患者下肢动脉病变超声影像学特点

目的探讨糖尿病足病患者下肢动脉病变的超声影像学特点,为糖尿病足病的超声检查提供临床资料。方法选取2013年10月—2015年12月该院接收的86例糖尿病足患者,采用西门子S2000彩色多普勒超声诊断仪检查下肢动脉8个节段,测量内-中膜厚度(IMT)并计算管径狭窄率,观察管腔内血流充盈情况及流速。结果 86例糖尿病足患者患侧与对侧8支下肢动脉管径、管径狭窄率、IMT厚度比较差异无统计学意义(P0.05),但均存在不同程度动脉硬化,发生率为100.0%,超声表现为IMT增厚、斑块形成、管腔狭窄或闭塞。结论糖尿病足患者下肢动脉各节段动脉均存在动脉硬化现象,而且与对侧相比差异不明显,根据超声影像学特点可以筛查下肢动脉病变,评估斑块、管腔狭窄程度等。     

彩色多普勒超声评价胫骨横向骨搬移术治疗老年糖尿病足的临床疗效

目的利用彩色多普勒超声对胫骨横向骨搬移术治疗老年糖尿病足(DF)的临床应用进行评价。方法老年DF患者38例,行胫骨横向骨搬移术治疗,采用彩色多普勒超声对手术前后老年患足的下肢动脉管壁、管腔及血流动力学改变进行评价。结果经胫骨横向骨搬移术治疗后,老年患者下肢动脉管径彩超斑块率、狭窄率、闭塞率均较手术前下降,但只有狭窄率手术前后的差异有统计学意义(P<0.05);手术后,患者的两侧股总动脉、腘动脉、胫后动脉和足背动脉的管腔内径均明显增大(均P<0.05);两侧股总动脉、腘动脉、胫后动脉和足背动脉的血流平均速度均明显减慢(均P<0.05);两侧股总动脉、腘动脉、胫后动脉和足背动脉的血流量均明显增加(均P<0.05)。结论彩色多普勒超声检测能客观反映胫骨横向骨搬移术后老年DF患者的血管病变程度,无创伤、简便易行、便于老年人接受,有助于对胫骨横向骨搬移术的临床效果提供血流动力学的依据。     

彩色多普勒超声检查对糖尿病下肢动脉病变患者的临床诊断价值

目的探究糖尿病下肢动脉病变患者经彩色多普勒超声检查的临床诊断价值。方法选取2019年7月—2020年7月该院收治的糖尿病患者60例设置为研究组,另选取同期于该院行健康体检者60名设置为对照组,所有患者均实施彩色多普勒超声检查,对比两组下肢动脉病变检出率、下肢动脉血流量、血管内径情况。结果研究组血管狭窄闭塞、粥样硬化斑、下肢动脉病变IMT检出率较对照组高,差异有统计学意义(P<0.05);研究组足背动脉、腘动脉及股动脉血流量、血管内径较对照组低,差异有统计学意义(P<0.05);研究组腘动脉与足背血流量比值、股总动脉与足背血流量比值低于对照组,差异有统计学意义(P<0.05)。结论糖尿病下肢动脉病变患者经彩色多普勒超声检查可快速诊断出下肢动脉斑块发生部位及数量,促进诊断准确率提升,临床诊断价值高,具有较高的临床推广及应用价值。     

Multi imaging approach with low field MRA in diabetic foot ulcer: hospital based study

The aim of study was to assess the usefulness of non-invasive imaging in patient of diabetic foot ulcer with low field MRA and determine the severity and extent of lower extremity arterial disease in diabetic patients with poor socio economic status. The present study is based on 38 patients who were referred to Department of Radiology with complaint of non-healing ulcer of lower limb of more than 6 weeks duration. The patients were subjected to plain radiographs, Duplex scanning with color flow imaging and MR angiography (non contrast enhanced). The modalities were used to detect vascular calcifications, osteomyelitis, bone resorption, deformities, thickening of arteries, plaques, spectral waveforms, collaterals. MRA was used to assess subjective calibre of vessels and presence of stenosis. The patients were categorised according to age and a note of ulcer duration made. Grade of ulcer was determined (wagner’s criteria) and note was made of severity of stenosis (cossman). Radiographs assessed bony destruction and vascular calcification. Doppler assessed degree of stenosis and vascularity. MRI gave a road map of vascular integrity. Integration of the tests provided a satisfactory diagnostic protocol to decide future prognosis and assessment of advancement of disease process. The data was subjected to calculation of mean, standard deviation and Pearson’s chi square test. p value?<?0.05 was considered to be stastically significant. Majority of patients were males (80%) and highest incidence was noted in fourth-fifth decade (43.33%). 47.37% presented with grade III ulcer. Duplex scanning with color flow imaging was more accurate and sensitive in picking up calcified arteries, focal plaques, stenosed arteries and abnormal arterial waveforms. These patients had co-existent lower extremity arterial disease with moderate to severe stenosis (i.e. on comparision with peak systolic velocity (PSV), p?<?0.05. Ulcer grade had stastically significant correlation with severity of stenosis, (p?<?0.05). However MRA did not corroborate the same findings. It proved to be only 60% sensitive when compared to Duplex scanning (100%). Plain radiographs and color Doppler evaluation plays an indispensable role in imaging and evaluating patients with chronic non-healing ulcer of diabetic foot. MRA gives crucial information regarding parameters like vascularity, degree of stenosis, and extent of disease. Not all patients in our set up afford CTA or CEMRA followed by DSA or cost of stenting. When the diagnostic workup in our cases suggested poor prognosis or non salvageable vascular compromise the patient was counseled against further investigation and advised surgery. By using this approach many financially constrained patients are benefitted from unnecessary and costly diagnostic workup.     

脂化前列腺素E1治疗糖尿病足疗效观察

目的　观察脂化前列腺素E1(Lipo PGE1)对糖尿病足 (DF)的治疗作用。　方法　选择DF患者 12 0例 ,分为Lipo PGE1治疗组和对照组 ,均以饮食控制及应用胰岛素 (Ins)控制血糖。治疗组则增加Lipo PGE1治疗 ,共 3周。对照组加罂粟碱治疗 3周。观察两组治疗前后足部病变改善、代谢紊乱、足背动脉内径、血流速度、尿白蛋白定量 (UAE)等的变化及治疗过程中出现的副作用。　结果　治疗组总有效率显著高于对照组 (P <0 0 1) ,治疗组Wagner分级Ⅱ～Ⅳ级患者有效率显著增高(P <0 0 5 )。两组患者治疗后UAE水平均显著下降 (P <0 0 5 ) ,治疗组上述各指标改善也明显优于对照组 (P <0 0 5 )。Lipo PGE1治疗过程中无严重副作用发生。　结论　Lipo PGE1通过改善足部的微循环和营养代谢而有效地改善DF患者的足部症状 ,加速溃疡愈合     

彩色多普勒超声在糖尿病患者下肢血管病变中的应用

目的探讨彩色多普勒超声在糖尿病患者下肢血管病变中的应用价值。方法选择2010年10月至2012年12月期间广东省人民医院院收治的2型糖尿病患者96例作为研究组,另选同期在我院进行健康体检者100名作为对照组。采用彩色多普勒超声诊断仪对两组受检者行下肢动脉血管血流动力学检测。比较分析两组受检者下肢动脉血管病变发生情况以及下肢动脉血流变学情况。结果与对照组比较,研究组2型糖尿病患者硬化斑块、血管狭窄以及血管闭塞等下肢动脉血管病变的发生率均明显提高,分别达63．54％、23．96％和11．46％,两组组间差异均有统计学意义（P〈0．05）。与此同时,与对照组比较,研究组下肢股动脉、胭动脉、胫动脉以及足背动脉血管内径均明显缩小,血流量均明显减少,频谱宽度均明显提高,两组间差异均有统计学意义（P〈0．05）。结论彩色多普勒超声在2型糖尿病患者下肢血管病变的早期诊断、治疗以及相关并发症的预防中均具有重要的临床应用价值。     

糖尿病下肢动脉病变的彩色多普勒诊断及其危险因素分析

目的 探讨彩色多普勒对糖尿病下肢动脉病变（ＬＥＡＤＤＰ）的诊断价值及有关ＬＥＡＤＤＰ的危险因素。方法 应用彩色多普勒检测了５０例糖尿病病人的双侧下肢动脉,同时与３０例正常人对照;应用多因素逐步回归分析方法对有关ＬＥＡＤＤＰ的危险因素作了探讨。结果 本组发现ＬＥＡＤＤＰ２１例,占４２％。多因素分析显示对ＬＥＡＤＤＰ影响最大的前二个因素依次是：空腹血糖水平升高及高密度脂蛋白－胆固醇水平降低。与糖尿病并     

Change in the amputation profile in diabetic foot in a tertiary reference center: efficacy of team working.

Diabetic foot is a serious complication of diabetes mellitus and the risk of lower extremity amputation is very high in this population when compared with people without diabetes. We have previously reported the lower-extremity amputation rate and significant factors in determining the risks for patients who had been admitted to Hacettepe University Hospital, a tertiary reference center for Turkey, between the years 1992 and 1996. In January 2000, a diabetic foot care team including an infectious diseases specialist, orthopaedic surgeons, endocrinologists, a plastic and reconstructive surgeon, a radiologist, and a diabetic foot nurse was assembled. To determine whether a change has occurred in the rate and the risk factors of lower extremity amputations after the establishment of this team, medical records of 66 patients (39 men, 27 women) with diabetic foot who had been admitted to Hacettepe University Hospital between 2000 and 2002 have now been retrospectively analysed. The grade distribution of diabetic foot according to Wagner classification was quite similar in the two studies (grade 1: 0 % vs. 4.5 %, grade 2: 15.6 % vs. 19.7 %, grade 3: 48 % vs. 33.3 %, grade 4: 24.4 % vs. 30.3 %, grade 5: 11.5 % vs. 12.1 % in the former and current study, respectively). The overall amputation rate in the current study was 39.4 % (36.7 % in the former study). Ray amputation (35 %) and below-knee amputations (30 %) were the two most commonly applied procedures. The rates of Syme, above knee, other amputations (i.e., Boyd, talonavicular amputations and partial calcanectomy) were 8 %, 8 % and 19 %, respectively. These data suggest that amputation is still a frequently encountered outcome for our patients with diabetic foot, but the amputation profile has changed. The implementation of a diabetic foot care team has relatively decreased the rate of major amputations in an attempt for limb salvage to improve the quality of life of the patients. Presence of osteomyelitis, peripheral vascular disease and gangrene still remain as significant predictors of amputation in our population.     

Change in amputation predictors in diabetic foot disease: effect of multidisciplinary approach

Diabetic foot disease causes important morbidity in diabetic population, and amputation due to diabetic foot disease occurs more often than in general population. We have been evaluating patients with diabetic foot disease in a multidisciplinary approach since year 2000. In the current study, we sought to investigate the change in amputation rate and its predictors in diabetic foot with a multidisciplinary team approach. Seventy-four patients (52 male, 22 female) hospitalised between January 2002 and December 2007 were retrospectively analysed. Sixteen out of 74 have undergone amputation. We found overall amputation rate as 21.6%, which is lower than previously reported from our institution (36.7 and 39.4%, respectively). Major amputations (syme, below-knee, above-knee) were applied to 11 patients (14.9%). A logistic regression model including osteomyelitis, peripheral neuropathy, peripheral vascular disease, hypertension, gangrene and age revealed that gangrene is now the only significant predictor for amputation. Our observations confirm that amputation rate has declined after implementation of a multidisciplinary team work, and risk factors apart from presence of gangrene are no longer amputation predictors in our centre.     

2型糖尿病伴发下肢动脉硬化闭塞症--附43例报告

目的探讨确诊2型糖尿病伴发下肢动脉硬化闭塞症的检查方法.方法主诉下肢或足部麻木或疼痛、溃疡、坏疽的2型糖尿病患者中,经下肢动脉节段性测压(踝/肱指数ABI)或彩色超声检查发现有下肢动脉缺血征象者,进一步作磁共振血管显像(MRA)、螺旋CT血管显像(SCTA)或数控动脉造影检查(DSA)以明确诊断.结果43例患者经ABI测定诊断为2型糖尿病合并下肢动脉硬化闭塞症,ABI在0.00～0.68范围,平均0.36.全组患者均作了MRA或SCTA,DSA检查,ABI无一例假阳性,最后确定43例中5例为主髂动脉段闭塞;19例为股腘动脉段闭塞;11例为股腘动脉伴腘动脉1～2分支闭塞;8例为膝以下动脉闭塞.43例根据造影结果分别接受了不同的手术或(和)药物治疗.结论节段性测压和彩超检查是初步诊断下肢动脉硬化闭塞症的无创检查方法,它的特点是简易、价廉、无损伤性、患者易接受;MRA,SCTA也属无损伤性检查,对确定动脉闭塞的部位、程度和范围均十分有益,最精确的检查还是插管动脉造影.