당뇨발과 동반된 중증 허혈성 하지에서의 다각적 접근 방법의 치료

Treatment of Multidisciplinary Approach of Critical Ischemic Limb with Diabetic Foot

  • 최현희 (한림대학교 의과대학 춘천성심병원 순환기학교실) ;
  • 김갑래 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 이재희 (한림대학교 의과대학 강동성심병원 정형외과학교실) ;
  • 이의수 (한림대학교 의과대학 강동성심병원 정형외과학교실)
  • Choi, Hyun-Hee (Department of Cardiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Gab-Lae (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Jae-Hee (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Eui-Soo (Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine)
  • 투고 : 2013.01.20
  • 심사 : 2013.02.14
  • 발행 : 2013.03.15

초록

Purpose: The purpose of this study is to evaluate treatment results of multidisciplinary approach of critical ischemic limb with diabetic foot. Materials and Methods: From March 2005 to March 2012, 674 diabetic foot patients were analyzed. Among them, 85 patients were neuroarthropathic type, 383 patients were infectious type, and 206 patients were ischemic type. The subjects were 206 patients who had critical ischemic limbs and major or minor amputations were done. Various single or combined treatment method before amputation was performed. We investigated their ABI, HbA1c, main occlusion lesion, limb salvage and hospitalization period by various treatment method. Results: Major amputation was 27 cases, minor amputation was 179 cases. Mean HbA1c was 8.2%, and mean ABI was 0.66. Main occlusion lesion was 6 cases at common iliac artery, 13 cases at external iliac artery, 9 cases at internal iliac artery, 11 cases at common femoral artery, 23 cases at deep femoral artery, 52 cases at superficial femoral artery, 35 cases at popliteal artery, 40 cases at posterior tibia artery, 35 cases at anterior tibial artery, 28 cases at peroneal artery, and 13 cases at dorsalis pedis artery. Major amputations were decreased, minor amputations were increased, and hospitalization period was reduced by treatment of multidisciplinary approach. Conclusion: Treatment of multidisciplinary approach, which include preoperation percutaneus transluminal angioplasty, vascular surgery, and amputation, of critical ischemic limb with diabetic foot had advantages of limb salvage and hospitalization period reduction.

키워드

참고문헌

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