Interventional Treatment for the Patients with Type 2 Diabetes Combined with Vascular Lesions of Lower Extremities_West China Medical Journal

Authors：

LI Sha ¹ , LIU Xiping ² ,  ZHONG Xiaowei ¹ , ZHOU Zheng ³ , LIANG Wei ³ , LUO Jing ³ , ZHOU Hong ⁴ , FU Xuquan ¹ , LIU Yidong ¹

1. Department of Endocrinology, 2. Deptartment of Interventional Therapy, 3. Department of Orthopaedics, 4. Department of B-ultrasound, the Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University,Chengdu, Sichuan 610031, P. R. China;

Corresponding author：

ZHONG Xiaowei, Email: ls1379@163.com

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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【摘要】　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　 To investigate the clinical significance of intervention therapy for patients with type 2 diabetes combined with vascular lesions of lower extremities.　Methods　 From January to May, 2009, four diabetic patients with vascular lesions of lower extremities were examined by Doppler ultrasonography and digital subtration angiography (DSA). All patients were treated by percutaneous transluminal angioplasty (PTA) or stenting therapy.　Results　 Stenoses and obstruction of lower extremity blood vessels were observed in all patients. After intervention therapy, vascular perfusion of lower extremities was improved and signs of rest pain and intermittent claudication were relieved; the skin temperature was improved, and the amputation level was apparently decreased.　Conclusion　 It suggests that DSA is effective in judging extend and location of blood vessel stenosis,and the interventional treatment could lead to a satisfying prognosis.

Citation： LI Sha,LIU Xiping,ZHONG Xiaowei,ZHOU Zheng,LIANG Wei,LUO Jing,ZHOU Hong,FU Xuquan,LIU Yidong. Interventional Treatment for the Patients with Type 2 Diabetes Combined with Vascular Lesions of Lower Extremities. West China Medical Journal, 2011, 26(1): 15-17. doi: Copy

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11.	Lawall H, Gorriahn H, Amendt K. Long-term outcomes after medical and interventional therapy of critical limb ischemia[J]. Eur J Intern Med, 2009, 20(6): 616-621.
12.	赵允, 王富军. 糖尿病下肢血管病变介入治疗进展[J]. 临床荟萃, 2010, 24(24): 2184-2186.
13.	Peeters P, Keirse K, Verbist J. Other endovascular methods of treating the diabetic foot[J]. J Cardiovasc Surg (Torino), 2009, 50(3): 313-321.

1. 　Winocour PH, Morgan J, Ainsworth A, et al. Association of British Clinical Diabetologists (ABCD): survey of specialist diabetes care services in the UK, 2000. 3. Podiatry services and related foot care issues[J]. Diabet Med, 2002, 19(Suppl 4): 32-38.
2. 　何利平, 冉兴无. 糖尿病足诊治进展[J]. 内科急危重症杂志, 2008, 14(4): 171-173.
3. 　李莎, 吕丽芳, 钟晓卫. 糖尿病足相关风险十年调查分析[J]. 中国全科医学, 2010, 13(8): 2539-2542.
4. 　Faglia E, Mantero M, Caminiti M, et al. Extensive use of peripheral angioplasty, particularly in frapopliteal, in the treatment of ischemic diabetic foot ulcers: clinical result s of a multicentric study of 221 consecutive diabetic subjects[J]. J Intern Med, 2002, 252 (3): 225-232.
5. 　Ha Van G. Management of a diabetic foot ulcer[J]. Rev Med Intern, 2008, 29(2): 238-242.
6. 　Lyden SP. Techniques and outcomes for endovascular treatment in the tibial arteries[J]. J Vasc Surg, 2009, 50(5): 1219-1223.
7. 　Williams R, Van Gaal L, Lucioni C. Assessing the impact of complications on the costs of Type 2 diabetes[J]. Diabetologia, 2002, 45(7): 13-17.
8. 　Dyet JF, Nicholson AA, Ettles DF. Vascular imaging and intervention in peripheral arteries in the diabetic patient[J]. Diabetes Metab Res Rev, 2000, 16(1): 16-22.
9. 　庄百溪．糖尿病周围血管病变的腔内治疗[J]. 医学研究杂志, 2006, 35(10): 69-70.
10. 　徐克, 于世平, 苏洪英, 等. 主-髂-股动脉闭塞性病变介入治疗的技术探讨及疗效观察[J]. 中华放射学杂志, 2005, 39(4): 383-387.
11. 　Lawall H, Gorriahn H, Amendt K. Long-term outcomes after medical and interventional therapy of critical limb ischemia[J]. Eur J Intern Med, 2009, 20(6): 616-621.
12. 　赵允, 王富军. 糖尿病下肢血管病变介入治疗进展[J]. 临床荟萃, 2010, 24(24): 2184-2186.
13. 　Peeters P, Keirse K, Verbist J. Other endovascular methods of treating the diabetic foot[J]. J Cardiovasc Surg (Torino), 2009, 50(3): 313-321.

West China Medical Journal

Interventional Treatment for the Patients with Type 2 Diabetes Combined with Vascular Lesions of Lower Extremities

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