Central Asian Journal of Medicine


Aim: to study the effectiveness of minimally invasive endovascular methods in the treatment of diabetic gangrene of the lower extremities, depending on the risk of loss of the limb. Material and methods: the results of the study and inpatient treatment of 323 patients for 2012-2018 were analyzed. with surgical complications of DFS in the Republican center of purulent surgery and surgical complications of diabetes at the 2nd clinic of the Tashkent Medical Academy. All patients suffered from type 2 diabetes. In 63% of cases (203), patients received insulin for the correction of blood sugar. Among male patients, there were 225 (69.6%) and 98 (30.4%) women. The neuroischemic form of diabetic foot syndrome was diagnosed in 271 (83.9%) patients, ischemic - in 52 (16.1%). The main survey methods were general laboratory data and studies of the state of the vascular bed. Result: a separate analysis of the obtained data revealed that large ulcerative defects (W3) were observed in 123 cases out of 323 - 38.1%, the average degree (W2) of the wound process was observed in 136 (42.1%), and the superficial wound defect (W1) noted in 43 (13.3%) cases. In 11 (3.4%) patients no wound defects were found on the foot. Severe ischemia (I3) of the limb was observed in 76 cases out of 323– 23.5%, moderate ischemia (I2) was detected in 135 patients (41.8%), and light level of foot ischemia was noted in 112 (34.6%) cases. Conclusions: carrying out LIACT in patients with DGLE with a high risk of loss of a limb after complete balloon angioplasty increases the chance of maintaining the limb support function to 88.7%. The use of a complex of minimally invasive X-ray endovascular treatments for DGLE even in patients with a high risk of loss of limb (77-94% wifi) reduces the frequency of hip amputation from 12.6 to 8.0% and mortality from 5.7 to 3.2%.

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