高频超声在糖尿病下肢周围神经、血管病变诊断的应用研究

目的 使用高频超声来评估糖尿病足患者的下肢周围神经、血管病变程度,为临床糖尿病下肢周围神经、血管病变的诊断提供依据,为临床选择恰当的治疗方案提供指导.方法 对46例糖尿病足患者（共59侧,A组）和健康志愿者89例（共178侧,B组）进行高频超声检查,测量踝管处胫后动脉内径、胫后动脉血流速度、胫神经横截面积.结果 胫后动脉内径A组为（1.56±0.31）mm,B组为（2.21±0.49）mm,两组比较差异有统计学意义（P＜0.01）;胫后动脉血流速度A组为（33.53±13.33） cm/s,B组为（47.6±9.44）cm/s,两组比较差异有统计学意义（P＜0.01）;胫神经横截面积A组为（3.55±0.58）mm2,B组为（2.85±0.28）mm2,两组比较差异有统计学意义（P＜0.01）.高频超声检查提示：A组胫后动脉内径明显缩小、胫后动脉血流速度明显减低,胫神经水肿明显.结论 糖尿病足患者高频超声检查有明显胫后动脉内径缩小、胫后动脉血流速度减低、胫神经水肿者,内科治疗控制血糖后应及时手术治疗.

Applied study on high frequency ultrasound in the diagnosis of diabetic peripheral nerve and vascular lesions

Objective To apply high frequency ultrasound to evaluate the degree of peripheral nerve and vascular lesions in patients with diabetic feet, so as to provide evidence to diagnose diabetic peripheral nerve and vascular lesions as well as guidance for appropriate treatment options in clinic. Methods 46 patients with diabetic feet （59 sides, Group A） and 89 healthy volunteers（178 sides, Group B）were tested by high frequency ultrasound, which included measuring the inside diameter of posterior tibial artery, blood flow velocity of posterior tibial artery and cross-sectional area of tibial nerve at tarsal tunnel.Results The inside diameter of posterior tibial artery of Group A was （1.56± 0.31） ram,Group B （2.21±0.49） mm,so the difference was statistically significant （ P 〈0.01）.The blood flow velocity of posterior tibial artery of Group A was （33.53±13.33） cm/s,Group B（47.6±9.44） cm/s,so the difference was statistically significant （ P 〈0.01）.The cross-sectional area of tibial nerve in Group A was （3.55 ±0.58） mm2 , Group B （2.85-0.28） mm2, which showed the difference between two groups was statistically significant（ P 〈0.01）.High frequency ultrasound showed that, in GroupA, the inside diameter of posterior tibial artery was significantly narrowed,the blood flow velocity of posterior tibial artery obviously slowed down, and tibial nerve edema was obvious.Conclusion For patients with diabetic feet-who get the following signs showed by high frequency ultrasound： inside diameter of posterior tibial artery is significantly narrowed, blood flow velocity of posterior tibial artery obvious- ly slowed down,and there was tibial nerve edema-should timely undergo surgery after being given medical treatment to control blood sugar.