经皮腔内血管成形术治疗糖尿病并发小腿动脉病变

目的 探讨经皮腔内血管成形术(PTA)治疗糖尿病并发小腿动脉狭窄或闭塞的临床应用价值. 方法 糖尿病并发小腿动脉病变39例,其中男28例,女11例,共56条患肢.术前经影像学检查了解患肢病变血管情况,对胫前和胫后动脉的远端(或足背动脉和足底动脉)至少有一条开放者行PTA.术中选择与病变血管相同直径的长球囊导管(长80～120 mm)进行球囊腔内血管成形. 结果 对56条患肢中的38条行PTA,34条患肢完成治疗(34/38, 89.47%),其中4足(有溃疡)症状明显缓解,其余症状基本消失,患肢皮肤颜色、皮温恢复正常.术后6个月内,9条(9/34,26.47%)患肢再次出现缺血症状,其中5条患肢病变血管再狭窄,4条患肢病变血管闭塞(1条为急性闭塞),再次进行血管成形治疗,患肢缺血症状消失. 结论 PTA是治疗糖尿病并发小腿动脉狭窄或闭塞较为安全、可行的有效方法 .

Clinical application of percutaneous transluminal angioplasty in the treatment of artery diseases of lower extrimities in diabetic patients

Objective To observe clinical value of percutaneous transluminal angioplasty (PTA) of stenosis or obstruction on crural arteries in diabetic patients. Methods Thirty-nine diabetic patients with crural arterial diseases underwent imaging examination prior to operation, and patients with at least one patent distal tibial artery (arteria dorsalis pedis or arteria plantaris) underwent PTA. Long balloon catheter (balloon length 80-120 mm) with the same diameter as arteries were used during the procedure of PTA. Results PTA were performed in 38 limbs, and 34 were successful (34/38, 89.47%). After operation, 4 limbs with ulcerative feet relieved obviously, the symptoms of the other limbs nearly disappeared, the color and temperature of skin became normal. During 6 months follow-up, ischemic symptom recurred in 9 limbs (9/34, 26.47%), restenosis occurred in 5 arteries (4 arteries were reoccluded, but ischemic symptoms disappeared after PTA again. Conclusion PTA is a relatively safe, feasible and effective therapy for stenosis or obstruction of crural arteries in diabetic patients.