摘要
目的研究超微血流成像技术在胫骨横向骨搬移治疗下肢慢性缺血性疾病中监测血管再生的应用价值。方法回顾性分析2019年5月至2020年12月接受胫骨横向骨搬移治疗的12例下肢缺血性疾病患者资料,其中男7例,女5例,年龄(64.0±16.6)岁(范围30~86岁)。12例中伴糖尿病足者10例,糖尿病史(14.4±8.3)年(范围5~30年);动脉硬化性闭塞症患者2例。12例均行胫骨横向骨搬移治疗,记录治疗前后的超微血流成像结果并进行比较,包括新生侧支血管数量与部位、血管直径、浸润深度等。结果12例在接受治疗后均发现明显的围绕下肢知名血管的新生侧支,侧支数量(3.25±2.73)支(范围1~8支)。12例共发现20支知名血管有侧支建立现象,其中11例共12支跖动脉(dorsal metatarsal artery,DMA)周围发现侧支建立,2例共3支足背动脉(dorsal pedis artery,DPA)周围发现侧支循环建立,2例共3支胫前动脉(anterior tibial artery,ATA)周围发现侧支循环建立,2例各有1支胫后动脉(posterior tibial artery,PTA)周围发现侧支循环建立。6例侧支建立于手术同侧下肢,2例侧支建立于手术对侧下肢,4例侧支建立于双侧下肢。结论胫骨横向骨搬移在临床应用中血管再生现象明显,超微血流成像可有效反映新生血管侧支生成的情况。
Objective To investigate the application value of superb microvascular imagingin monitoring angiogenesis in the treatment of chronic ischemic diseases of lower limbs by tibial transverse transport.Methods From May 2019 to December 2020,12 patients with ischemic diseases of lower limbs who received tibial transverse transport therapy were retrospectively analyzed,including 7 male patients and 5 female patients,aged 30-86 years,with an average age of 64.0±16.6 years.Among them,there were 10 patients with diabetic foot,with a disease course of 5-30 years(mean 14.4±8.3 years),and 2 patients with arteriosclerosis obliterans.The results of lower extremity superb microvascular imaging before and after treatment were recorded and compared.Results After treatment,12 patients were found to have obvious new vessels around the artery of lower extremity,the number of vessels 1-8,the average number of 3.25±2.73.We found that a total of 12 patients 20 inherent lower limb artery collateral established,collateral circulation was found around 12 dorsal metatarsal artery(DMA)in 11 patients,around 3 dorsal pedis artery(DPA)in 2 patients,around 3 anterior tibial artery(ATA)in 2 patients,and around 1 posterior tibial artery(PTA)in 2 patients.The lateral branches were established in ipsilateral lower limbs in 6 patients,contralateral lower limbs in 2 patients,and bilateral lower limbs in 4 patients.Conclusion The phenomenon of angiogenesis is obvious in the clinical application of tibial transverse transport.Superb microvascular imaging can effectively reflect the degree of promoting the establishment of collateral circulation by tibial transverse transport.
作者
王斌
李娟
张永红
王栋
张进
张兴东
乔虎云
刘宏
王宝娜
王兴华
Wang Bin;Li Juan;Zhang Yonghong;Wang Dong;Zhang Jin;Zhang Xingdong;Qiao Huyun;Liu Hong;Wang Baona;Wang Xinghua(Shanxi Medical University,Taiyuan 030001,China;Department of Ultrasound,Second Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Orthopedics,Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2021年第11期677-686,共10页
Chinese Journal of Orthopaedics
基金
山西省重点研发计划项目(201803D31126)。
关键词
缺血后处理
诊断显像
侧支循环
外固定器
治疗结果
Ischemic postconditioning
Diagnostic imaging
Collateral circulation
External fixators
Treatment outcome
