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对2 6 7例Ⅰ～Ⅴ期糖尿病足部溃疡患者用彩色多谱勒超声检测双下肢动脉血管情况。在全身综合治疗的基础上,溃疡局部彻底清创后用黄芪液加适量短效胰岛素外敷局部,观察溃疡处肉芽组织生长时间(GT) ,溃疡愈合时间(HT) ,治愈率,截肢率。结果:①显著狭窄者19例,中度2 8例,轻度34例,血管病变发生率为30 34%。②其GT和HT均显著长于患肢无动脉血管病变者(均P <0 .0 5 ) ;③且有血管病变的患者截肢率高达35 % ,亦显著高于无血管病变的足部溃疡患者(P <0 .0 1) ,且严重血管病变时不仅溃疡病变严重,而且截肢率高达82 % ;④GT和HT与下肢血管狭窄的程度呈显著的正相关关系(r1=0 .4 6 79,P <0 . 0 5 ,r2 =0 .5 377,P <0. 0 5 )。结论:下肢血管病变不仅是糖尿病足部溃疡的主要原因之一,而且也是影响疗效及预后非常重要因素,提示改善下肢血流状态将有助于足部溃疡的愈合。
Color Doppler echocardiography was used to detect arterial blood vessels of lower extremities in 267 patients with stage I-V diabetic foot ulcer. On the basis of systemic treatment, ulcer was partially debrided with local application of astragalus plus appropriate amount of short-acting insulin to observe the growth of granulation tissue (GT), ulcer healing time (HT), cure rate and amputation rate. Results: ① There were 19 cases with significant stenosis, 28 cases were moderate, 34 cases were mild, and the incidence of vascular lesions was 30 34%. ② The GT and HT were significantly longer than those without arterial disease (all P <0.05). ③ The amputation rate of patients with vascular lesions was as high as 35%, which was also significantly higher than those with foot-ulcer without vascular disease (P <0.01). In severe angiopathy, not only the severity of ulcer disease but also the rate of amputation was as high as 82%. (4) There was a significant positive correlation between GT and HT and the degree of lower extremity vascular stenosis (r1 = 0.4679, P <0. 05, r2 = 0 .5 377, P <0. 05). Conclusion: The lower extremity vascular disease is not only one of the main causes of diabetic foot ulcer, but also a very important factor affecting the curative effect and prognosis. It suggests that improving the lower limb blood flow state will help the healing of foot ulcer.