Angiographic Study of the Diabetic Foot

糖尿病足之血管攝影探討

邱育德(Yu-Te Chiu) ； 周治剛(Chih-kang Chou) ； 賴春生(Chung-Sheng Lai) ； 蔡志成(Chih-Cheng Tsai) ； 林幸道(Sin-Daw Lin)

《中華民國重建整形外科醫學會雜誌》 4卷4期 (1995/12) Pp. 249-256

https://doi.org/10.7096/JPRSA.199512.0249

摘要

從1989年1月至1993年1月止，共搜集61位接受下肢血管攝影的糖尿病足患者，並對其血管攝影之變化作進一步研究。依據血管攝影中血管阻塞的程度，我們將前脛動脈、腓動脈、後脛動脈、足背及蹠動脈之阻塞程度給予2~0分的分數，再把這些分數加起來與臨床結果做比較及分析（從8分至0分共分9個等級）結果顯示患肢的分數若為8分、7分或6分，則此患肢應儘量以予保留，若分數為5分、4分或3分，則依臨床症狀區分；若是Wagner分類的第一或第二級則患肢應儘量保留，若是第三至第五級則患肢可能遭踝下或膝下截肢，如果患肢的分數是2分或1分或0分，則不論如何處理都會遭到膝下截肢的命運，臨床結果與所列分數有如下關係，即分數愈高預後愈好，分數愈低預後愈差。所以在處理糖尿病足時血管攝影可提供作為預後及處理方式的參考。

並列摘要

Sixty-one diabetic patients with foot ulcer who had received angiography examination were evaluated in this study from January 1989 to January 1993. Based on angiographic figures, the subjects were statistically analyzed by the existence of the clogging of the main arteries in the lower leg. They were categorized into 9 grades by the degree of patency, stenosis, and occlusion of the anterior tibia! artery, peroneal artery, posterior tibial artery, dorsalis pedis and plantar artery.
When the subjects received a score of 8, 7, or 6 (category 1), their limbs could be preserved and the operations were conservative. If the scores were 5, 4, or 3 (category 2), and the Wagner's classification of the wound was either grade I or II, the limbs could also be preserved; but if the Wagner's classification were grade III, IV or V, the limb would need minor or major amputation. When the subject scored 2, 1 or 0 (category 3), his/her limb would be amputated in spite of aggressive management.
In the management of the diabetic foot, this angiographic study can provide prospective and prognostic information and help to outline the strategy of therapy.

並列關鍵字

diabetic foot ； angiography