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确定外周动脉疾病诊断的最佳非侵入性测试,以预测糖尿病足治愈在内血管再血管化后的患者

Francisco Javier Álvaro-Afonso¹, Yolanda García-Álvarez¹, Esther Alicia García-Morales¹

¹Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.

Healthcare (Basel, Switzerland)

|August 29, 2024

概括

皮下氧气压力 (TcPO2) 和脚压力 (TP) 最好预测在重新血管化后糖尿病足的愈合. 这些非侵入性测试有助于预测伤口愈合和截肢存活率.

科学领域:

血管外科血管外科
糖尿病学糖尿病学
非侵入性诊断非侵入性诊断

背景情况:

糖尿病足 (DFU) 存在重大风险,包括截肢和死亡率.
血管内膜再血管化是危及血液循环的DFU的关键治疗方法.
预测复血管化后的愈合结果对于患者管理至关重要.

研究的目的:

确定最有效的非侵入性测试,以预测内血管再血管化后的DFU愈合.
评估各种血管和组织氧化参数的预后值.
为了将测试结果与临床结果相关联,例如愈合率和无截肢生存率.

主要方法:

一项前性观察性研究,涉及28名DFU患者接受内血管再血管化.
测量脚静脉压 (TP),脚静脉压 (AP),脚腕压指数 (ABPI),脚腕压指数 (TBPI),穿皮氧气压 (TcPO2) 和皮肤 perfusion 压力 (SPP).
在重血管化之前和四周后进行了测试,结果在六个月后进行评估.

主要成果:

在手术后六个月观察到71.43%的愈合率.
在预测伤口愈合时,TCPO2 (切断值24 mmHg) 和TP (切断值46 mmHg) 显示出最高的灵敏度 (分别为0.89和0.70).
大幅截肢发生在14.3%的患者中.

结论:

TcPO2和TP是最可靠的非侵入性标志物,用于预测内血管再血管化后的DFU伤口愈合.
微循环评估对于DFU患者的预后至关重要.
这些发现支持将TCPO2和TP整合到常规的DFU管理协议中.

关键词:

糖尿病患者的糖尿病脚糖尿病足糖尿病足诊断诊断诊断诊断诊断诊断静脉内血管再血管化疗法周围动脉疾病周围动脉疾病

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