Author/Editor		Salapura, Vladimira; Šurlan, Miloš; Blinc, Aleš; Popovič, Peter
Title		Ohranitev uda in preživetje pri bolnikih s sladkorno boleznijo in ishemijo spodnjih okončin
Translated title		Limb salvage and survival in diabetic patients with lower limb ischemia
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 40, št. Suppl 3
Publication year		2001
Volume		str. 169-73
Language		slo
Abstract		We have retrospectively analysed the results of treatment of lower limb ischemia in 63 diabetic patients (27 females and 36 males, average age 73.5 years) who were identified in a group of 138 randomly selected patients among those who had undergone lower limb arteriography during hospitalisation at the Department of Vascular Medicine at the Department of Radiology of the Clinical Centre of Ljubljana in the year 1998. The reason for lower limb arteriography was claudication in 18 patients (29%), chronic critical ischemia in 42 patients (66%), and acute ischemia in patients 3 (5%). After the arteriography, a revascularization procedure was performed in 32 patients (51%), among whom the 3 patients with acute ischemia had successful embolectomy, 24 patients were treated endovascularly and 5 patients surgically. Thirty patients (47%) were treated conservatively and one patient with primary amputation. The patient's status was reassessed after an average of 24 months, ranging from 19 to 33 months. Among the 18 patients with claudication 2 patients died, one because of stroke and another because of worsening chronic obstructive pulmonary disease with respiratory failure, but all patients retained their limb during the survival or follow up time. Among the 42 patients with chronic critical ischemia, 33 (79%) salvaged the limb during the survival or follow up time,15 after revascularization and 18 with conservative treatment. Nine patients (21%) had an amputation, 4 below and 5 above the knee. One amputation was primary, 2 amputations followed endovascular treatment, and 6 were performed after conservative treatment. During the follow up period 13 patients (31%) with chronic critical ischemia died, 5 because of stroke, 3 because of acute myocardial infarction and 5 of an unknown cause. (Abstract truncated at 2000 characters)
Summary		Retrospektivno smo analizirali rezultate zdravljenja ishemije spodnjih udov pri 63 bolnikih s sladkorno boleznijo (27 ženskami in 36 moškimi, povprečno starimi 73,5 let), ki smo jih identificirali v skupini 138 naključnoizbranih bolnikov med vsemi bolniki, ki so bili bolnišnično oskrbljeni na Kliničnem oddelku za žilne bolezni Kliničnega centra v Ljubljani in smo jim na Kliničnem inštitutu za radiologijo Kliničnega centra v Ljubljani v letu 1998 opravili arteriografijo spodnjih udov zaradi ishemije. Razlogi za arteriografijo so bili intermitentna klavdikacija pri 18 bolnikih (29 %), kronična kritična ishemija pri 42 bolnikih (66 %) in akutna ishemija uda pri 3 (5 %) bolnikov. Po opravljeni arteriografiji je bil napravljen revaskularizacijski poseg na udih pri 32 bolnikih (51 %), med katerimi so bili vsi trije bolniki z akutno ishemijo uspešno zdravljeni z embolektomijo, 24 bolnikov smo zdravili endovaskularno in 5 kirurško. Trideset bolnikov (47 %) smo zdravili konzervativno in enega bolnika (2 %) s primarno amputacijo. Stanje bolnikov smo ocenili po povprečno 24 mesecih, v razponu od 19-33 mesecev. Med 18 bolniki z intermitentno klavdikacijo sta 2 umrla, eden zaradi možganske kapi in drugi zaradi poslabšanja kronične obstruktivne pljučne bolezni z odpovedjo dihanja, vsi bolniki pa so v času opazovanja ali času preživetja ohranili ud. Med 42 bolniki s kronično kritično ishemijo je ud ohranilo 33 bolnikov (79 %), od tega 15 bolnikov po revaskularizacijskih posegih in 18 ob konzervativnem zdravljenju. Devet bolnikov (21 %) je utrpelo amputacijo, 4 pod kolenom in 5 nad kolenom. Ena amputacija je bila primarna, 2 sta sledili endovaskularnemu zdravljenju, 6 pa konzervativnemu zdravljenju. Med časom opazovanja je umrlo 13 (31 %) bolnikov s kronično kritično ishemijo; 5 zaradi možganske kapi, 3 zaradi srčnega infarkta, pri 4 pa vzroka smrti nismo ugotovili. (Izvleček skrajšan pri 2000 znakih)
Descriptors		DIABETES MELLITUS ARTERIAL OCCLUSIVE DISEASES SURVIVAL ANALYSIS INTERMITTENT CLAUDICATION ISCHEMIA EMBOLECTOMY AMPUTATION