高晓辉 刘 巍 李春峰

摘要：目的 观察Ilizarov胫骨横向骨搬移（tibial transverse transport，TTT）技术对糖尿病足患者的疗效。方法选取2017年1月至2021年12月于我院接受TTT技术治疗的52例2型糖尿病足患者作为研究对象，观察治疗前后疗效。结果 1例患者在治疗期间出现严重感染并于术后2周行截肢处理，创面愈合率和保肢率为98.1%，溃疡复发率19.6%;与治疗前相比，患者术后3个月足部皮温明显升高，而VAS评分均明显降低，差异具有统计学意义（P<0.05）。结论 TTT技术可明显促进糖尿病足患者的创面愈合，提高保肢率，值得临床进一步推广，但术前应对患者进行严格的病情评估，充分考虑患者的风险获益。

关键词：胫骨横向骨搬移;糖尿病足;临床观察

【Abstract】Objective To observe the effect of Ilizarov tibial transverse transport （TTT） technique on diabetic foot patients. Methods 52 patients with type 2 diabetic foot who were treated with TTT technology in our hospital from January 2017 to December 2021 were selected as the research objects to observe the efficacy before and after treatment. Results One patient developed severe infection during the treatment and was treated with amputation 2 weeks after the operation. The wound healing rate and limb salvage rate were 98.1%， and the ulcer recurrence rate was 19.6%. Compared with before treatment， the patient was 3 months after the operation. The skin temperature was significantly increased， while the VAS scores were significantly reduced， the difference was statistically significant （P<0.05）. Conclusion TTT technology can significantly promote the wound healing of diabetic foot patients and increase the limb salvage rate. It is worthy of further clinical promotion. However， patients should be strictly evaluated before surgery， taking full account of the risks and benefits of patients.

[Keywords] tibia lateral bone transfer; diabetic foot; clinical observation

糖尿病足是长期罹患糖尿病患者在出现下肢血管和神经病变基础上，合并细菌感染引起的踝及以远皮肤软组织感染及溃疡，伴或不伴深层软组织破坏。根据国际糖尿病联盟发布的数据，2019年我国的糖尿病患病率约为10.9%[1]，而糖尿病足已经成为中国糖尿病患者最常见的主住院原因，约有35%糖尿病患者在疾病过程中可出现糖尿病足[2]。糖尿病足给患者带来众多危害，具有高复发率、致残率和死亡率的特点。研究表明[3-4]，未行手术的Wagner 4级以上患者的死亡率高到54%，对患者的生命健康和生活质量带来严重威胁，同时还进一步增加了社会经济负担。俄罗斯临床专家 Ilizarov等基于肢体再生与功能重建理论首先创立的胫骨横向骨搬移技术（tibial transverse transport，TTT）为糖尿病足的治疗提供了新的思路和方……