中华医学杂志(英文版)2007,Vol.120Issue(2):106-109,4.
Surgical treatment of 82 patients with diabetic lower limb ischemia by distal arterial bypass
Surgical treatment of 82 patients with diabetic lower limb ischemia by distal arterial bypass
GU Yong-quan 1WANG Zhong-gao 1ZHANG Jian 1QI Li-xing 1YU Heng-xi 1LI Jian-xin 1LI Xue-feng 1GUO Lian-rui 1LUO Tao 1CUI Shi-jun1
作者信息
- 1. Department of Vascular Surgery, Xuan Wu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China
- 折叠
摘要
Abstract
Background Diabetic lower limb ischemia is a serious complication of diabetes mellitus.This study was conducted to investigate the effectiveness of distal arterial bypass treatment in diabetic patients with lower limb ischemia. Methods From July 2000 to July 2004, 96 lower limbs of 82 diabetic patients (type 2) with severe lower limb ischemia were treated in Xuan Wu Hospital. Arterial bypass with femoro-popliteal polytetrafluoroethylene (PTFE) and graft-tibial autologous grafts was performed on 311 limbs (32.3%). Popliteal-tibial artery bypass alone was performed on 22 limbs (22.9%). Combined iliac artery stenting, femoro-popliteal artery PTFE graft bypass, and graft-tibial artery autologous graft bypass was performed on 12 limbs (12.5%), and femoro-tibial artery graft bypass was performed on 10 limbs (10.4%). Popliteal-tibial-pedal artery graft bypass was performed on 7 limbs (7.3%). Results Arterial grafts in 92 limbs of 79 patients were patent on discharge. Three patients with 4 ischemic limbs (3.7%)died of respiratory failure 12 hours, 3 days and 7 days after operation respectively. Early operation success rate was 96.3% (79/82). Graft patency rate of patients on discharge was 95.8% (92/96). The short-term total effectiveness rate was 83.3% (80/96). Foot ulcer healing rate was 35.7% (10/28). 97.4% (75/77) patients were followed up for a mean of 13.5 months. The long-term total effective rate was 80.7% (71/88). The total amputation rate was 4.5% (4/88). Mortality was 4.5%. The total graft patency rate was 90.9% (80/88).Conclusion In the treatment of diabetic foot, distal lower limb arterial bypass can help to avoid amputation or lower the amputation level, and may promote foot ulcer healing and improve patient's quality of life.关键词
diabetic angiopathies/diabetes complications/lower extremity/distal arterial bypassKey words
diabetic angiopathies/diabetes complications/lower extremity/distal arterial bypass分类
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GU Yong-quan,WANG Zhong-gao,ZHANG Jian,QI Li-xing,YU Heng-xi,LI Jian-xin,LI Xue-feng,GUO Lian-rui,LUO Tao,CUI Shi-jun..Surgical treatment of 82 patients with diabetic lower limb ischemia by distal arterial bypass[J].中华医学杂志(英文版),2007,120(2):106-109,4.