Janneau D, Lagneau P, Cormier J M
J Mal Vasc. 1980;5(2):115-8.
416 cases of diabetic arterial disease were treated over a period of 5 years, the majority of patients (71%) having trophic problems from the outset. -- Clinically, distinction must be drawn between patients suffering from "ischemic" disturbances, where healing is obtained after an appropriate surgical procedure (reconstructive surgery, if not lumbar sympathectomy) and so-called "diabetic" gangrene, where cure is obtained only by isolated excision. -- Few of the patients had lesions making reconstructive surgery possible, and the latter was thus only rarely indicated (13% of cases). -- So-called "major" amputations through leg or thigh were necessary in 16% of cases. Distal excision, if necessary atypical, thus in 84% of cases led to healing with preservation of weight-bearing.
在5年的时间里,共治疗了416例糖尿病动脉疾病患者,大多数患者(71%)从一开始就有营养问题。——临床上,必须区分患有“缺血性”障碍的患者和所谓的“糖尿病性”坏疽患者,前者在进行适当的外科手术(重建手术,若不是腰交感神经切除术)后可实现愈合,而后者只有通过单独切除才能治愈。——很少有患者的病变适合进行重建手术,因此这种手术很少被采用(占病例的13%)。——16%的病例需要进行所谓的通过腿部或大腿的“大”截肢手术。必要时进行远端切除,如有必要进行非典型切除,因此在84%的病例中可实现愈合并保留负重功能。