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华西医学  2011 

2型糖尿病合并下肢血管病变介入治疗探讨

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Keywords: 2型糖尿病,糖尿病血管病变,糖尿病足,下肢,血管介入治疗

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Abstract:

【】 目的 探讨2型糖尿病合并下肢血管病变血管内介入治疗的临床意义。 方法 2009年1-5月对4例2型糖尿病合并下肢血管病变患者,根据血管狭窄情况选择不同介入治疗方式,行下肢动脉造影及动脉球囊扩张或支架成形术。 结果 4例患者均有表现静息痛及间歇性跛行,下肢血管超声显示糖尿病下肢动脉有不同程度的斑块、狭窄与血栓形成,病变累及下肢股动脉、髂动脉及胫前、足背动脉。介入治疗后患者下肢血管灌注得到明显改善,静息痛及间歇性跛行明显改善,皮温改善,需要截肢患者截肢平面显著降低。 结论 通过下肢血管DSA造影检查,准确了解糖尿病患者下肢血管的阻塞部位及程度,在保守治疗基础上选择不同方式的介入治疗,有助于下肢血管病变的明显改善。?【Abstract】 Objective Toinvestigatetheclinicalsignificanceofinterventiontherapyforpatientswithtype2diabetescombinedwithvascularlesionsoflowerextremities. Methods FromJanuarytoMay,2009,fourdiabeticpatientswithvascularlesionsoflowerextremitieswereexaminedbyDopplerultrasonographyanddigitalsubtrationangiography(DSA).Allpatientsweretreatedbypercutaneoustransluminalangioplasty(PTA)orstentingtherapy. Results Stenosesandobstructionoflowerextremitybloodvesselswereobservedinallpatients.Afterinterventiontherapy,vascularperfusionoflowerextremitieswasimprovedandsignsofrestpainandintermittentclaudicationwererelieved;theskintemperaturewasimproved,andtheamputationlevelwasapparentlydecreased. Conclusion ItsuggeststhatDSAiseffectiveinjudgingextendandlocationofbloodvesselstenosis,andtheinterventionaltreatmentcouldleadtoasatisfyingprognosis.

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