Ilizarov微循环重建技术治疗Wagner 4级糖尿病足临床疗效分析

发布时间：2018-04-19 12:56

本文选题：糖尿病足 + Ilizarov技术　；参考：《中国矫形外科杂志》2017年04期

【摘要】：[目的]总结Ilizarov微循环重建技术对Wagner 4级糖尿病足的治疗效果。[方法]2015年3月~2016年3月,采用Ilizarov微循环重建技术治疗10例Wagner 4级糖尿病足患者。男8例,女2例;左足6例,右足4例;年龄45~82岁,平均(61.8±8.9)岁。均经保守治疗失败,有行截肢指征。术前患足缺血性疼痛强度根据视觉模拟量表,7~10分6例,4~6分4例。术前行CT血管造影证实患肢动脉均存在不同程度的狭窄与闭塞。糖尿病足病程15~102 d,平均(52±6.8)d。[结果]术后10例患足缺血性疼痛均获明显缓解,足部坏疽溃疡创面均愈合,平均治愈时间(72.0±20.5)d,均未截肢。未发生术后胫骨截骨处继发骨折、伤口感染等并发症。10例均获随访,随访时间3个月~1年,平均(6.3±1.2)个月。末次随访时患足缺血性疼痛强度,0分8例,1~3分2例,与术前比较差异有统计学意义(P0.001)。10例患者均对术后结果感到满意。[结论]Ilizarov微循环重建技术对糖尿病足有较好的临床疗效,术后病情改善明显,可明显降低截肢率,减轻患者痛苦,提高生活质量,是一种值得推广的技术。
[Abstract]:[objective] to summarize the therapeutic effect of Ilizarov microcirculation reconstruction technique on Wagner grade 4 diabetic foot.[methods] from March 2015 to March 2016, 10 patients with Wagner grade 4 diabetic foot were treated with Ilizarov microcirculation reconstruction technique.Male 8 cases, female 2 cases, left foot 6 cases, right foot 4 cases, age 45 ~ 82 years (mean 61.8 卤8.9) years.All failed conservative treatment with amputation indication.According to visual analogue scale 6 cases had 4 ~ 6 scores according to visual analogue scale before operation.Ct angiography was performed before operation to confirm the stenosis and occlusion of all the affected limb arteries.The course of diabetic foot was 15 ~ 102 days, with an average of 52 卤6.8 days.[results] Ischemic pain in all the 10 cases were relieved obviously, the wound of gangrene ulcer healed, the average cure time was 72.0 卤20.5 days, and no amputation was found.There were no secondary fractures at the tibial osteotomy after operation. All the 10 cases were followed up for 3 months to 1 year with an average of 6.3 卤1.2 months.At the last follow-up, there were 8 cases with 1 ~ 3 scores and 2 cases with ischemic pain in foot. The difference was statistically significant compared with that before operation (P 0.001). 10 cases were satisfied with the postoperative results.[conclusion] Ilizarov microcirculation reconstruction technique has a good clinical effect on diabetic foot. It can obviously reduce amputation rate, alleviate the suffering of patients and improve the quality of life. It is worth popularizing.
【作者单位】：四川省绵阳市中心医院骨科;国家康复辅具研究中心附属康复医院;
【分类号】：R587.2

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