The Clinical Value Of CTA Used For Determination The Amputation Level Of Diabetic Foot

Diabetes is a common disease.With healthcare and economic development, the incidence of diabetic patients is increasing every year, the patients'life extension, it induce the opportunities of lower limb vascular complications increase. even though now there are a variety of method to treat diabetic foot, but still severe cases need amputation. With the development of CTA technology, lower limb cta is widely used clinically, the majority of clinicians accept this method for it's direct results, but whether the amputation level determined by CTA results are safe and effective requires further study.ObjectiveTo investigate the clinical features of severe diabetic foot, and analysis of the advantages of contrast CTA compared to traditional testing methods and how to use the CTA to determine the appropriate and safe amputation.Materials and methods160patients with severe diabetic foot do comprehensive physical examination and related auxiliary check. When the glycemic controled, group A contained44patients amputate according the Doppler ultrasound findings, Group B,30patients were combined with the views of the family members of patients and doctors'experience to amputate, group C40patients according to digital subtraction angiography (DSA) score to amputate, and group D46patients, according CT angiography and clinical signs score to amputate, after operation,give treatment of conventional antibiotics, anti-inflammatory, drainage, control of blood sugar stable and change dressing, wound healing was observed.ResultsThe average age of hospital diabetic foot patients is (65.35±7.18) years, the average blood pressure is (145±23)/(80±12) mmHg, The average BMI is (24.8±1.5) kg/m2, smokers accounted for40.5%,the patients with the history of alcohol consumption accounted for25.5%. Peripheral neuropathy, coronary heart disease, lower extremity vascular disease are the most common complication in diabetic patients.71to80years old have a high incidence of diabetic foot, the average course is7to11years.A major cause of diabetic foot ulcer is trauma; research data in wagner classification3to4patients are the majority,the foot ulcers more often in the toe.Group A of40patients with incision Grade A healing rate is24.8%, grade B healing rate is45.2%, the re-amputation rate is30%; Group B of30patients with incision Grade A healing rate is10%, grade B healing rate is20%, the re-amputation rate is70%; Group C of46patients with incision Grade A healing rate is65%, grade B healing rate is 20%, the re-amputation rate is10%; Group D of46patients with incision Grade A healing rate is65%, grade B healing rate is21.7%, the re-amputation rate is13.3%.By the x2test, group A and group B, group C, group D have significant differences (P<0.05), group B and group C group D have significant difference (P<0.05), group C and group D have no significant difference (P>0.05).ConclusionsCTA can help determine diabetic foot amputation level, and is superior to Doppler ultrasound and doctors experience,similar to DSA.