RESUMO
Treatment results were analyzed in 1244 patients with diabetic angiopathy. 882 of them had necrotic suppurative affection of feet. Distal affection predominated among patients with neuroischemic form of diabetic foot syndrome. Combined affection of popliteofemoral and tibial-foot segments was revealed in 46.3% of observations. Stenosis of ileofemoral arterial segment was discovered in 40 (4.9%) patients, occlusion--in 27 (3.3%) patients. Reconstructive operations on aorta and great vessels were carried out to 520 patients; among them: aorto-femoral bifurcational bypass--to 38 patients, proximal popliteofemoral bypass--to 191 patients, distal popliteofemoral bypass--to 195 patients, tibiofemoral bypass--to 96 patients. Thrombosis in reconstruction region was observed in 41% of patients after popliteofemoral bypass including 16% in short-term period and 25% after a year. Low frequency of large amputations amounting 20.4% and low lethality (3.2%) indicated that bypass operations are highly effective in this group of patients.
Assuntos
Arteriopatias Oclusivas/cirurgia , Angiopatias Diabéticas/cirurgia , Pé Diabético/cirurgia , Procedimentos de Cirurgia Plástica , Procedimentos Cirúrgicos Vasculares , Adulto , Idoso , Idoso de 80 Anos ou mais , Prótese Vascular , Feminino , Artéria Femoral/cirurgia , Humanos , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Artéria Poplítea/cirurgia , Artérias da Tíbia/cirurgiaAssuntos
Pé Diabético/tratamento farmacológico , Relaxantes Musculares Centrais/uso terapêutico , Tolperisona/uso terapêutico , Adulto , Idoso , Desbridamento , Pé Diabético/cirurgia , Neuropatias Diabéticas/tratamento farmacológico , Neuropatias Diabéticas/cirurgia , Desarticulação , Vias de Administração de Medicamentos , Quimioterapia Combinada , Humanos , Hipoglicemiantes/uso terapêutico , Pessoa de Meia-Idade , Relaxantes Musculares Centrais/administração & dosagem , Síndrome , Tolperisona/administração & dosagem , Resultado do Tratamento , Vasodilatadores/uso terapêuticoRESUMO
Of 3721 patients with diabetic lesions of the foot treated 2416 (65%) patients have been operated. The rise of urgent hospitalization rate (over 90%) unfavourably influenced the results of the treatment and contributed to increased frequency of high amputations of the extremity. The proposed system for evaluation of the condition and scope of the combined treatment resulted in decrease of mortality among operated patients from 14.7% to 9.8% and among not operated ones--from 20.5% to 5.5%. The suggested classifications of complicated forms of the "diabetic foot" syndrome provided proper evaluation of the prognosis and individual approach to the choice of treatment measures.