一种三阶段的顺序性手术方法,以更有效地管理临床4期糖尿病足的治疗
Fang Zhang1,2, Yu Guo1,2, Wenduo Zhang1,2
1Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Frontiers in surgery
|December 15, 2025
概括
这项研究表明,三阶段的手术方法有效治疗晚期糖尿病足 (DFU). 增加皮层横向运输 (TTT) 手术可以改善血管功能和患者的结果,而不会增加愈合时间.
科学领域:
- 血管外科 血管外科
- 糖尿病足管理 糖尿病足管理
- 肢体救援手术 肢体救援手术
背景情况:
- 临床阶段4 糖尿病足 (DFU) 存在重大治疗挑战,往往导致重大截肢和延长愈合.
- 综合外科伤口治疗 (ISWT) 模式提供了一种连续的方法来管理复杂的DFU.
研究的目的:
- 评估基于ISWT模式的三阶段顺序手术方法的有效性,用于管理临床第四阶段的DFU.
- 为了比较在治疗的第三阶段将皮层横向运输 (TTT) 手术纳入手术的好处.
主要方法:
- 对23名患有第四阶段DFU的患者进行了回顾性分析.
- 组A (11名患者) 接受了三阶段的ISWT治疗,包括TTT在第3阶段. B组 (12名患者) 接受了相同的治疗,但没有TTT.
- 评估的结果包括住院治疗,愈合时间,复发,重新干预,截肢,死亡率,VAS,ABI,2-PD和血管增生症的CTA.
主要成果:
- 与B组 (P=0.975) 相比,A组没有再次出现PTA (P=0.037) 和类似的愈时间.
- 结局,截肢和死亡率在各组之间是可比的 (P>0.05).
- 手术后一年,A组表现出VAS,ABI和2-PD的改善,下肢动脉特征得到改善,与B组不同.
结论:
- 顺序的三阶段ISWT方法有效地管理临床第四阶段的DFU.
- 在第三阶段加入TTT手术可以增强皮肤透光血管造形手术 (PTA) 的好处,改善血管功能和患者的治疗结果.
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