微创医学

目的比较胫骨中段皮质横向搬移（MTCTT）和胫骨近端皮质横向搬移（PTCTT）治疗糖尿病足溃疡（DFU）的疗效和安全性。方法选择接受MTCTT治疗的100例DFU患者为MTCTT组，同期接受PTCTT治疗且一般资料与MTCTT组均衡可比的90例DFU患者为PTCTT组。对比两组患者的手术相关情况、足部溃疡愈合率、愈合时间、截肢率、复发率及术后并发症发生率。结果所有患者均获随访，随访时间3～24个月，平均5.2个月。MTCTT组手术时间、住院时间、术中出血量均长/多于PTCTT组，差异均有统计学意义（均P＜0.05）。两组足部溃疡愈合率、愈合时间、截肢率和复发率比较，差异均无统计学意义（均P＞0.05）。MTCTT组术后骨折、截骨块区域感染的发生率均高于PTCTT组，差异均有统计学意义（均P＜0.05）。结论MTCTT和PTCTT均能有效地促进糖尿病溃疡愈合，降低复发率及截肢率，是治疗DFU的有效方法。但PTCTT创伤更小，并发症发生风险更低，是更理想和安全的手术方式。

ObjectiveTo compare the efficacy and safety of middle tibial cortex transverse transport (MTCTT) and proximal tibial cortex transverse transport (PTCTT) in the treatment of diabetic foot ulcer (DFU). MethodsA total of 100 DFU patients who received MTCTT treatment were selected as the MTCTT group, and 90 DFU patients who received PTCTT treatment in the same period and whose general information was comparable with that of the MTCTT group were selected as the PTCTT group. The operation-related conditions, foot ulcer healing rate, healing time, amputation rate, recurrence rate and postoperative complications incidences were compared between the two groups. ResultsAll patients were followed up for 3 to 24 months, with an average of 5.2 months. The operation time, hospital stay, and intraoperative blood loss in the MTCTT group were longer/more than those in the PTCTT group, with statistically significant differences (all P＜0.05). There were no statistically significant differences in the foot ulcer healing rate, healing time, amputation rate and recurrence rate between the two groups (all P＞0.05). The incidences of postoperative fracture and osteotomy site infection in the MTCTT group were higher than those in the PTCTT group, with statistically significant differences (all P＜0.05). ConclusionBoth MTCTT and PTCTT can effectively promote the healing of diabetic ulcer, reduce the recurrence rate and amputation rate, and are effective methods for the treatment of DFU. However, PTCTT is a more ideal and safer surgical method with less trauma and lower risks of complications.