Jakanov Murat K, Zhakiev Bazylbek S, Karsakbayev Uteugaly G, Kurmanbayev Bulat A, Taishibayev Kairat R, Sagynganov Serik K
Department of General Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
Department of Surgical Diseases No. 2, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
Med J Islam Repub Iran. 2021 Aug 18;35:106. doi: 10.47176/mjiri.35.106. eCollection 2021.
Diabetic foot syndrome (DFS) causes damage to the peripheral arteries in 50% of patients with diabetes mellitus (DM). The purpose of this study was to evaluate the efficacy of endovascular interventions, stenting, and balloon angioplasty for the treatment of patients with purulent and necrotic lesions in DFS. This was a retrospective study. During 2019-2020, stenting and balloon angioplasty were performed in 51 patients (study group) with purulent and necrotic complications of diabetic foot with limb ischemia. There were 32 women (62.7%) and 19 men (37.3%). The age of the patients varied from 45 to 81 years. Endovascular interventions were performed in combination with conservative therapy and topical treatment on 2 to 3 days after the debridement of the purulent lesions. To assess the outcomes of endovascular interventions, we studied the nature of changes in arterial circulation in the lower extremities. The mean blood flow velocity was calculated using the Doppler ultrasonography. The study was performed on the popliteal artery (PA), the posterior tibial artery (PTA), and on the dorsalis pedis artery. In this study, patients were divided into 2 groups: the study group- those who received endovascular intervention- and the control group- those who received only conservative therapy, which included local treatment without surgery. The weightbearing function of the foot at discharge from the hospital was preserved in 94.2% (48 patients) of the study group and in 73.4% (22 patients) of the control group. During the next 6 months, repeated small foot surgeries were required in 7.3% (3 patients) of patients from the study group and in 20% (4 patients) of patients from the control group. Six months after discharge, the weightbearing function of the foot was preserved in all the patients from the study group available for follow-up and in 85% of the patients from the control group. The results of the study demonstrate the positive corrective effects of endovascular interventions, stenting, and balloon angioplasty on the clinical course of ischemic and neuroischemic forms of DFS.
糖尿病足综合征（DFS）在50%的糖尿病（DM）患者中会导致外周动脉损伤。本研究的目的是评估血管内介入治疗、支架置入术和球囊血管成形术对治疗DFS中伴有化脓性和坏死性病变患者的疗效。这是一项回顾性研究。在2019年至2020年期间，对51例患有糖尿病足化脓性和坏死性并发症且伴有肢体缺血的患者（研究组）进行了支架置入术和球囊血管成形术。其中女性32例（62.7%），男性19例（37.3%）。患者年龄在45岁至81岁之间。在化脓性病变清创术后2至3天，血管内介入治疗与保守治疗及局部治疗联合进行。为了评估血管内介入治疗的效果，我们研究了下肢动脉循环变化的性质。使用多普勒超声计算平均血流速度。研究在腘动脉（PA）、胫后动脉（PTA）和足背动脉上进行。在本研究中，患者分为两组：研究组——接受血管内介入治疗的患者；对照组——仅接受保守治疗的患者，保守治疗包括不进行手术的局部治疗。研究组94.2%（48例）患者出院时足部的负重功能得以保留，对照组73.4%（22例）患者出院时足部的负重功能得以保留。在接下来的6个月中，研究组7.3%（3例）患者需要再次进行小型足部手术，对照组20%（4例）患者需要再次进行小型足部手术。出院6个月后，研究组所有可进行随访的患者以及对照组85%的患者足部的负重功能得以保留。研究结果表明，血管内介入治疗、支架置入术和球囊血管成形术对缺血性和神经缺血性DFS的临床病程具有积极的矫正作用。
