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目的探讨2型糖尿病合并下肢血管病变临床特点及下肢血管介入治疗的临床效果。方法对20例2型糖尿病合并下肢血管病变的患者行下肢血管彩超,CTA及DSA造影检查,根据血管狭窄情况选择介入治疗方式,全部病例均行动脉造影及动脉球囊扩张或支架成形术。结果 20例糖尿病患者均表现为静息痛及间歇性跛行,下肢血管超声及CTA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,所有患者均行胰岛素控制血糖,抗凝、活血化淤改善微循环,治疗后患者下肢血管灌注得到明显改善,临床症状、体征均明显缓解,踝肱指数明显提高,差异有统计学意义(P<0.05)。结论下肢血管DSA造影检查可以准确了解糖尿病患者下肢血管的阻塞部位及程度,血管内介入治疗安全、有效,具有推广应用价值。
Objective To investigate the clinical features of lower extremity vascular lesions and the clinical effects of lower extremity vascular intervention in type 2 diabetes mellitus. Methods Twenty patients with type 2 diabetes mellitus complicated with lower extremity vascular disease underwent lower extremity vascular ultrasound, CTA and DSA. Interventional therapy was selected according to the vascular stenosis. All cases underwent arterial angiography and arterial balloon dilation or stenting. Results All 20 diabetic patients showed resting pain and intermittent claudication. Lower extremity vascular ultrasound and CTA showed that the lower extremity arteries of diabetic patients had different degrees of plaque, stenosis and thrombosis. The lesion involved the lower extremity femoral artery, iliac artery and anterior tibial and foot Dorsal artery. After interventional therapy, all patients underwent insulin control of blood glucose, anticoagulation, blood circulation to improve microcirculation, after treatment of patients with lower limb vascular perfusion was significantly improved, clinical symptoms and signs were significantly relieved, ankle brachial index increased significantly, the difference was statistically significant Significance (P <0.05). Conclusion DSA angiography of lower extremity can accurately understand the occlusion site and extent of lower extremity blood vessels in diabetic patients. Intravascular interventional therapy is safe and effective and has the value of popularization and application.