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[糖尿病患者足部湿性坏疽的治疗]

[Treatment of moist gangrene of the foot in patients with diabetes mellitus].

作者信息

Prokhorov A V, Deshkevich V S

出版信息

Khirurgiia (Mosk). 1991 Jul(7):11-4.

PMID:1833586
Abstract

The authors generalized their experience in the treatment of 159 patients aged 21 to 84 with diabetes mellitus and pyonecrotic lesions of the lower limbs. On the basis of the results of rheovasography, aortoarteriography, and roentgenography of the foot bones they concluded that to prognosticate the possibility of preserving the supporting function of the limb, not only the level and extent of the gangrene but also the state of the main and the collateral blood flow in the limb and the spread of bone destruction in the foot must be taken into account. Pathogenetic nonoperative treatment including antibacterial therapy, transfusion of hemo- and rheomodulators, and the use of hemosorption made it possible to convert moist to dry gangrene in 86.8% of patients, expand the indications for "minor" amputations, and reduce the number of high amputations from 56.2 to 35.8% and the total mortality from 10.2 to 4.4%.

摘要

作者总结了他们治疗159例年龄在21至84岁之间患有糖尿病和下肢脓性坏死性病变患者的经验。根据血流图、主动脉造影和足部骨骼X线检查结果,他们得出结论,为了预测保留肢体支撑功能的可能性,不仅要考虑坏疽的程度和范围,还要考虑肢体主要和侧支血流的状况以及足部骨质破坏的范围。包括抗菌治疗、血液和血液流变学调节剂输注以及血液吸附在内的病因性非手术治疗,使86.8%的患者的湿性坏疽转变为干性坏疽,扩大了“小”截肢的适应症,并将高位截肢的比例从56.2%降至35.8%,总死亡率从10.2%降至4.4%。

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