Shah D M, Chang B B, Fitzgerald K M, Kaufman J L, Leather R P
Vascular Surgery Service, Albany Medical College, New York.
Am J Surg. 1988 Aug;156(2):133-5. doi: 10.1016/s0002-9610(88)80373-8.
Infrapopliteal bypass in diabetic patients has been associated with lower rates of patency and limb salvage than in nondiabetic patients. We prospectively compared the patency and limb salvage rates of in situ tibial artery bypass in diabetic and nondiabetic patients. Of 681 in situ bypasses performed for limb salvage over a 7 year period, 387 (57 percent) were carried out in diabetic patients and 294 (43 percent), in nondiabetic patients. Indications for operation most commonly included gangrene or ulceration (74 percent of the diabetic group and 49 percent of the nondiabetic group). Otherwise, the two patient groups were similar. Cumulative patency rates at 1 and 5 years were similar (91 and 74 percent for diabetic patients and 90 and 76 percent for nondiabetic patients, respectively). Limb salvage rates were also not significantly different (96 and 86 percent at 1 and 5 years, respectively, for diabetic patients and 99 and 94 percent, respectively for nondiabetic patients). Despite the unfavorable pattern of atherosclerosis in diabetic patients, the results of tibial arterial reconstructions showed patency and limb salvage rates similar to those seen in nondiabetic patients.
与非糖尿病患者相比，糖尿病患者的腘下动脉搭桥术通畅率和保肢率较低。我们前瞻性地比较了糖尿病患者和非糖尿病患者原位胫动脉搭桥术的通畅率和保肢率。在7年期间为保肢而进行的681例原位搭桥术中，387例（57%）在糖尿病患者中实施，294例（43%）在非糖尿病患者中实施。最常见的手术指征包括坏疽或溃疡（糖尿病组为74%，非糖尿病组为49%）。除此之外，两组患者相似。1年和5年的累积通畅率相似（糖尿病患者分别为91%和74%，非糖尿病患者分别为90%和76%）。保肢率也无显著差异（糖尿病患者1年和5年分别为96%和86%，非糖尿病患者分别为99%和94%）。尽管糖尿病患者存在不利的动脉粥样硬化模式，但胫动脉重建的结果显示通畅率和保肢率与非糖尿病患者相似。
