腔内血管成形术治疗糖尿病足部溃疡

目的探讨腔内血管成形术（PTA）治疗糖尿病足溃疡（DFU）的疗效。 方法回顾性分析2016年1月—2020年1月，在我院接受PTA治疗的39例DFU患者的临床资料，该组患者均同时接受重组牛碱性成纤维细胞生长因子（rb-bFGF）治疗，分析PTA手术成功率，术后1周视觉模拟评分（VAS评分）和踝肱指数（ABI）变化、不良反应及15 d和30 d的溃疡创面收缩率。 结果39例患者均存在患肢膝下动脉及其靶动脉的严重狭窄及节段性闭塞，对靶动脉进行PTA治疗，35例患者接受了单纯PTA治疗，4例合并股动脉狭窄的患者接受了PTA联合支架植入治疗。PTA成功率为92.3%（36/39例），36例患者Angiographosome体系的术终可见缺血区的血管染色阳性，3例患者PTA失败，未能有效开通靶动脉，Angiographosome体系的术终可见缺血区的血管染色阴性。有3例患者出现穿刺部位皮下血肿，未予特殊处理，逐渐消退。PTA术后1周VAS评分由术前的（8.8 ± 0.7）分下降至（5.3 ± 0.5）分（P < 0.05），患肢ABI从术前的0.37 ± 0.08上升至0.42 ± 0.09（P < 0.05）。39例患者均进行了随访，36例进行PTA成功的患者在术后15 d和30 d时溃疡创面收缩率均明显高于PTA失败的患者（35.5% vs 5.1%和84.7% vs 6.4%），差异均具有统计学意义（P < 0.01）。 结论PTA治疗DFU安全有效，可以为DFU患者提供一种可选的治疗方式。

Percutaneous transluminal angioplasty in the treatment of diabetic foot ulcer

ObjectiveTo investigate the efficacy of percutaneous transluminal angioplasty (PTA) in the treatment of diabetic foot ulcer (DFU). MethodsThe clinical data of 39 patients with DFU underwent PTA in our hospital between January 2016 and January 2020 were retrospectively analyzed.All patients were received recombinant bovine basic fibroblast growth factor (rb-bFGF). The success rate of PTA, visual analogue scale (VAS) score and ankle-brachial index (ABI) changes at 1 week after operation, adverse reactions, and ulcer wound shrinkage rate at 15 and 30 days after operation were analyzed. ResultsA total of 39 patients (23 males and 16 females, with an average age of 76.5 ± 5.8 years) were included in this study. Among the 39 patients, 35 patients were treated with PTA alone, and 4 patients were treated with PTA plus stent placement. The success rate of PTA was 92.3% (36/39), 36 patients showed positive blood vessel staining on the angiographosome, and 3 patients failed PTA with the negative blood vessel staining on the angiographosome. Subcutaneous hematomas were occurred in 3 patients and needn't treatment. The pain score of the affected limb was decreased from 8.8 ± 0.7 to 5.3 ± 0.5 (P < 0.05) one week after PTA. The ankle brachial index of the affected limb was increased from 0.37 ± 0.08 to 0.42 ± 0.09 (P < 0.05) one week after PTA. The contraction rates of the ulcer at 15 and 30 days after PTA were 35.5% and 84.7% of patients with PTA successful and were 5.1% and 6.4% of patients who failed PTA (all P < 0.01), respectively. ConclusionsPTA is an effective method in the management of DFU.