Results of treatment of diabetic patients with chronic critical ischemia of the lower limb
Journal Title: Міжнародний ендокринологічний журнал - Year 2018, Vol 14, Issue 5
Abstract
Background. In Ukraine, the current shortage of qualified vascular surgical care, especially for diabetic people, remains relevant. The diabetic patients with chronic critical ischemia of the lower limb often undergo unreasonable conservative treatment in conditions of a general surgical hospital with an unsatisfactory result. The purpose of the work is to compare the results of conservative treatment with the results of endovascular and open surgical interventions in patients with diabetes mellitus and chronic critical ischemia of the lower limb. Materials and methods. The results of surgical treatment of 240 type 2 diabetes patients with chronic critical ischemia of the lower extremity were analyzed. Group A1 included 42 (17.5 %) patients who had shunting in the artery of the lower leg or feet. The group A2 consisted of 101 (42.1 %) patients with balloon angioplasty. Group B contained 97 (40.4 %) patients received conservative therapy. In order to correctly compare the results of different types of treatment, we developed a technique for calculating of the coefficient of amputation level. Results. Among 42 patients in the group A1, 4 (9.5 %) patients had amputation at the thigh, 3 (6.7 %) — at the level of the leg, 6 (14.3 %) — transmetatarsal resection of the foot, 14 (33.3 %) — amputation of fingers, in 15 (35.7 %) patients the support function of the foot was not impaired. The coefficient of amputation level in A1 group was 1.48. Among 101 patients in the group A2, 2 (2 %) had amputation at the thigh, 4 (4 %) — at the level of the leg, 16 (16 %) — transmetatarsal foot resection, and 19 (19%) — amputation of the fingers, in 60 (60%) patients the support function of the foot was not impaired. The coefficient of amputation level in A2 group was 0.78. Among 97 patients in group B, 22 (22.7 %) had amputation at hip level, 29 (29.9%) — at the level of the leg, 6 (6.2 %) — transmetatarsal foot resection, 11 (11.3 %) — amputation of fingers, in 29 (29.9 %) patients the support function of the foot was not impaired. The coefficient of amputation level in the group B was 2.79. Conclusions. The presented coefficient of amputation level calculation technique can be used to compare the treatment outcomes in the groups of diabetic patients with chronic critical ischemia of the lower limb against the background of stenotic-occlusive lesions of the arteries of the popliteo-cruro-pedal segments treated with various therapeutic methods. The best annual results of the support function of the foot were observed in A2 group patients. The worst annual results were observed in group B patients received conservative treatment.
Authors and Affiliations
S. N. Didenko
Keywords
Related Articles
- EP ID EP402256
- DOI 10.22141/2224-0721.14.5.2018.142684
- Views 61
- Downloads 0
Managing patients with manifest, subclinical and postsurgical hypothyroidism (literature review)
The review presents data of the most common complication after hemithyroidectomy — hypothyroidism, as well as postoperative hypothyroidism: its subclinical and manifest forms, incidence, the time of occurrence after the...
Pathogenetic significance of proinflammatory cytokines and dyslipidemia in the development of cardiovascular complications in patients with hypothyroidism
Background. The manifestation of violations in the morphofunctional state of the cardiovascular system is on one of the first places in the symptomatology of hypothyroidism, which is associated with various direct and in...
The Early Diagnosis of Hypothyroidism as a Factor in the Progression of Osteoarthritis and Comorbid Processes, the Features of Phytocorrection
Objective: to study the prevalence and forms of hypothyroidism in patients with osteoarthritis (OA) and to investigate the effect of phytomedication zobofit on the functional and morphological status of the thyroid gland...
Management of Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer
The article provides recommendations for the diagnosis of thyroid nodules: presents ultrasound criteria of benign nodules and different grade of malignancy, indications for fine needle aspiration biopsy, describes the di...
Early and delayed reaction of the Hif-1α protein in the hippocampal fields on ischemia-reperfusion in rats with streptozotocin-induced diabetes mellitus
Background. The role of the transcriptional hypoxia-inducible factor-1α (Hif-1α) in the pathogenesis of hypoxic damage and diabetes mellitus (DM) is proved, although molecular mechanisms underlying dysfunction of this fa...