经皮氧分压监测在老年糖尿病足病人诊治中的应用

doi:10.3969/j.issn.1003-9198.2024.02.018

摘要/Abstract

摘要： 随着人们生活习惯和饮食模式的改变,糖尿病的发病率逐年增长,糖尿病足是糖尿病最常见、最严重的并发症之一。血管病变引起足部供血及微循环障碍是糖尿病足发生、发展的重要原因。因此,检测老年糖尿病病人肢端局部缺血情况对预测糖尿病足溃疡风险、指导血管重新建立、评估各种治疗方法的效果、判断预后有着重要的指导意义。经皮氧分压检测是一种经济、可信度高、可重复、操作简洁、无创性的血管病变检查方法,用于糖尿病足病人时可很好地反映下肢血管尤其踝以下皮肤微循环状态,进而反映周围动脉灌注情况,可为糖尿病足的预防及治疗提供客观、量化的参考。

中图分类号:

R 589.1

彭茂, 车亚梅, 鲁严. 经皮氧分压监测在老年糖尿病足病人诊治中的应用[J]. 实用老年医学, 2024, 38(2): 181-184.

参考文献

[1] WHITING D R, GUARIGUATA L, WEIL C, et al. IDF diabetes atlas:global estimates of the prevalence of diabetes for 2011 and 2030[J]. Diabetes Res Clin Pract, 2011, 94(3): 311-321.
[2] 中华医学会糖尿病学分会.《中国2型糖尿病防治指南(2020版)》[J].中华糖尿病杂志, 2021, 13(4): 317-411.
[3] SANZ-CORBALÁN I, LÁZARO-MARTÍNEZ J L, GARCÍA-ÁLVAREZ Y, et al. Digital deformity assessment prior to percutaneous flexor tenotomy for managing diabetic foot ulcers on the toes[J]. J Foot Ankle Surg, 2019, 58(3): 453-457.
[4] SCHMIDT B M, MUNSON M E, ROTHENBERG G M, et al. Strategies to reduce severe diabetic foot infections and complications during epidemics (STRIDE)[J]. J Diabetes Complications, 2020, 34(11): 107691.
[5] 邵蕊.老年糖尿病足的中西医认识及治疗进展[J]. 天津医科大学学报, 2022, 28(4): 452-455.
[6] 中华医学会糖尿病分会.中国2型糖尿病防治指南(2020年版)[J]. 中华内分泌代谢杂志, 2021,37(4): 311-398.
[7] 王芳, 李素梅.经皮氧分压测定在糖尿病足病中的临床应用[J]. 安徽卫生职业技术学院学报, 2010, 9(3): 18-19.
[8] 陈伟, 姜利国, 沙德潜.经皮氧分压在预防及诊治糖尿病足中的作用[J]. 临床诊疗进展, 2018, 32(7): 77-79.
[9] 叶林芳, 郑红英, 巫丽萍.2型糖尿病患者经皮氧分压测定结果观察及影响因素分析[J]. 临床护理杂志, 2016, 15(6): 16-19.
[10] 潘斌斌, 马建华.经皮氧分压测定在糖尿病足和周围动脉病变诊治中的应用[J]. 中国糖尿病杂志, 2013, 21(12): 1142-1143.
[11] 董晓颖, 邓武权, 陆德宾, 等.2型糖尿病患者经皮氧分压与神经传导功能测定的相关性分析[J]. 解放军医学杂志, 2013, 38(1): 39-43.
[12] 彭青.应用经皮氧分压测试检查糖尿病足的研究进展[J].糖尿病新世界, 2017, 20(19): 196-198.
[13] TESFAYE S, SELVARAJAH D. Advances in the epidemiology, pathogenesis, and management of diabetic peripheral neuropathy[J].Diabetes Metab Rev, 2012, 28(Suppl 1): 8-14.
[14] American Diabetes Association. Summary of revisions to the 2011 clinical practice recommendations[J].Diabetes Care, 2011, 34(Suppl 1):S3.
[15] VINCENT A M, CALLAGHAN B C, SMITH A L, et al. Diabetic neuropathy: cellular mechanisms as therapeutic targets[J]. Nat Rev Neurol, 2011, 7(10):573-583.
[16] OWOLABI M O, IPADEOLA A. Total vascular risk as a strong correlate of severity of diabetic peripheral neuropathy in Nigerian Africans[J]. Ethn Dis, 2012, 22(1): 106-112.
[17] 王国凤, 徐宁, 杨涛.经皮氧分压在2型糖尿病周围神经病变中的变化及其临床意义[J].中国糖尿病杂志, 2017, 25(9): 822-826.
[18] BOUHON A J M, VILEIKYTE L, TENNVALL G R, et al. The global burden of diabetic foot disease[J]. Lancet, 2005, 366(9498): 1719-1724.
[19] JIANG Y, RAN X, JIA L, et al.Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China[J]. Int J Low Extrem Wounds, 2015, 14(1):19-27.
[20] 何蕊, 刘芳.糖尿病周围神经病变导致糖尿病足的机制[J]. 中华医学杂志, 2016, 96(32): 2536-2538.
[21] 金星陈, 颖越, 沈赘, 等. 不同方法检测2型糖尿病外周血管疾病差异性比较的观察[J]. 中国糖尿病杂志, 2013, 21(1): 45-47.
[22] 翁焕, 严励.经皮氧分压测定在糖尿病足中的临床应用[J]. 国际内科学杂志, 2008, 35(7): 387-389.
[23] 李艳, 杨郁文.经皮氧分压检查在糖尿病足检查中的应用[J]. 护理研究, 2014, 28(4B): 1374-1375.
[24] FAGLIA E, CLERICI G, CAMINITI M, et al. Predictive values of transcutaneous oxygen tension for above-the-ankle amputation in diabetic patients with critical limb ischemia[J]. Eur J Vasc Endovasc Surg, 2007, 33(6): 73l-736.
[25] POREDOS P, RAKOVEC S, GUZIC S B. Determination of amputation level in ischaemic limbs using TcPO₂ measurement[J]. VASA, 2005, 34(2): 108-112.
[26] STRAUSS M B. Hyperbaric oxygen as an intervention for managing wound hypoxia: its role and usefulness in diabetic foot wounds[J]. Foot Ankle Int, 2005, 26(1): 15-18.
[27] ZGONIS T,GARBALOSA J C,BURNS P, et al. A retrospective study of patients with diabetes mellitus after partial foot amputation and hyperbaric oxygen treatment[J]. J Foot Ankle Surg, 2005, 44(4): 276-280.
[28] NIJNIKOSKI J. Hyperbaric oxygen therapy of diabetic foot ulcers, transcutaneous oxymetry in clinical decision making[J]. Wound Repair Regen, 2003, 11(6):458-461.
[29] CASELLI A, LATINI V, LAPENNA A, et al. Transcutaneous oxygen tension monitoring after successful revascularization in diabetic patients with ischaemic foot ulcers[J]. Diabet Med, 2005, 22(4): 460-465.
[30] WAGNER H J, SCHMITZ R, ALFKE H, et al. Influence of precutaneous transluminal angioplasty on transcutaneous oxygen pressure in patients with peripheral arterial occlusive disease[J]. Radiology, 2003, 226(3): 797-797.
[31] ARROYO C I, TRITTO V G, BUCHBINDER D, et al. Optimal waiting period for foot salvage surgery following limb revascularization[J]. J Foot Ankle Surg, 2002, 41(4): 228-232.
[32] PEDRINI L, MAGNONI F. Spinal cord stimulation for lower limb ischemic pain treatment[J].Interact Cardiovasc Thorac Surg, 2007, 6(4): 495-500.
[33] HORSCH S, SCHULTE S, HESS S. Spinal cord stimulation in the treatment of peripheral vascular disease: results of a single center study of 258 patients[J]. Angiology, 2004, 55(2): 111-118.
[34] UBBINK D T, GERSBACH P A, BERG P, et al.The best TcPO₂ parameters to predict the efficacy of spinal cord stimulation to improve limb salvage in patients with inoperable critical leg ischemia[J]. Int Angiol, 2003, 22(4): 356-363.
[35] KALANI M, SILVEIRA A, BLOMBACK M, et al. Beneficial effects of dalteparin on haemostatic function and local tissue oxygenation in patients with diabetes, severe vascular disease and foot ulcers[J]. Thromb Res, 2007, 120(5): 653-661.
[36] MELILLO E, FERRARI M, BALBARINI A, et al. Transcutaneous oxygen and carbon dioxide levels with iloprost administration in diabetic critical limb ischemia[J]. Vasc Endovascular Surg, 2006, 40(4): 303-311.