摘要
糖尿病足介入治疗的患者存在年龄大、合并症多并有对比剂的应用等情况,故围手术期有其复杂性;本文查阅了近年来国内外文献,进行整理、分类、比较、分析,对于糖尿病足介入治疗围手术期处理总结如下:①血糖控制目标及措施;②预防和治疗对比剂肾病(CIN);③积极控制糖尿病足感染;④仔细评估心脏风险,应用β受体阻滞剂、血压控制、血脂控制和阿司匹林等措施保护心脏;⑤注意改善微循环、抗血小板、抗凝、降纤等治疗。除以上所述外,糖尿病足患者一般合并有糖尿病慢性并发症的2项以上,全身各脏器储备功能差,需全身各脏器及营养状况评价;围术期还可能出现糖尿病急性并发症。所以,糖尿病足介入治疗的围手术期处理需全面、细致、深入的综合治疗。
As the patients who are going to receive interventional treatment for diabetic foot are usually aged with many complications and also will receive contrast agents, their perioperative situation is definitely very complicated. The authors have consulted a number of medical documents about this subject that have been published both at home and abroad in recent years. The relevant materials are arranged, classified, compared and analyzed. Here is the summary concerning the perioperative management of interventional therapy for diabetic foot. （A） The control goal and method of blood glucose level during the perioperative period. （B） The prevention and treatment of contrast- induced nephropathy. （C） Actively controlling the infection of diabetic foot. （D） Carefully evaluating the risks of cardiac events, protecting the heart by using 15 acceptor blockers and aspirin, and controlling blood pressure and hyperlipoidemia. （E） Improving microcirculation, use of antiplatelet, anticoagulation, defibrination medication, etc. Aside from the above mentioned managements, as the patients with diabetic foot are usually complicated by two or more chronic complications, their reserve function of all visceral organs are in poor condition, and a careful assessment of the function of all visceral organs as well as the body nutritional status is essentially needed. Acute complications due to diabetes mellitus may occur during the perioperative period. Therefore, comprehensive, careful and thorough managements should be carried out for patients with diabetic foot during the perioperative period of intervention therapy.（J Intervent Radiol, 2013, 22： 780-785）
出处
《介入放射学杂志》
CSCD
北大核心
2013年第9期780-785,共6页
Journal of Interventional Radiology
关键词
糖尿病足
围术期
介入治疗
对比剂肾病
diabetic foot
perioperative period
interventional therapy
contrast- induced nephropathy
