Qing-Yi Meng, Shandong University, Jinan Central Hospital affiliated director of Vascular Surgery, chief physician, professor. City professional and
technical elite talent, the young experts with outstanding contributions. Under the tutelage of Vascular Surgery at the internationally renowned experts,
Chinese Academy of Sciences Professor Wang Zhonggao. Since 1981, has been engaged in vascular surgery. Who went to the United States, Japan, Korea, India,
Malaysia, Germany, Italy, to study the exchange.
� main diagnosis and treatment of diseases
Arteries Disease Series: thoracic and abdominal aortic aneurysm, carotid artery (body) aneurysm, subclavian artery aneurysm, hepatic artery, splenic artery
aneurysm, superior mesenteric artery aneurysm, iliac artery aneurysm, popliteal aneurysms.
Series of arterial occlusive disease: lack of carotid atherosclerosis stenosis hyperinsulinemia, hyperlipidemia lack of vertebral atherosclerosis stenosis,
subclavian stenosis lack of arteriosclerosis hyperlipidemia, abdominal aortic stenosis - occlusive disease, renal artery stenosis with ischemic hypertension,
mesenteric artery narrow lack of hyperlipidemia, iliac - femoral artery stenosis lack of hyperinsulinemia, hyperlipidemia lack of popliteal artery stenosis,
Takayasu arteritis, thromboangiitis obliterans, various parts of arterial thrombosis and / or embolization, each part of traumatic arteriovenous fistula and
pseudoaneurysm.
Veno-occlusive disease series: acute and chronic deep vein thrombosis, Budd-Chiari syndrome, superior vena cava syndrome, splenomegaly, portal hypertension.
Venous reflux disease series: lower extremity varicose veins, lower extremity deep venous valve insufficiency.
Other: various parts of hemangioma, lymphatic edema.
� Subject Characteristics
Thoracic and abdominal aortic aneurysm endovascular graft exclusion; diabetic foot, vasculitis, arteriosclerosis obliterans in interventional and surgical
treatment; minimally invasive treatment of varicose veins; interventional and surgical treatment of Budd-Chiari syndrome; carotid artery stent angioplasty or
endarterectomy; renal artery stenosis stenting Deng Jun reached the international advanced level.
Diabetic foot is a serious complication of diabetes is lower extremity vascular disease, neuropathy and infection together the results often appear in
patients with foot numbness, swelling, pain, ulcers and even gangrene, diabetes foot pain caused by a combination of factors , skin deep ulcers, gangrene and
other diseases collectively. Traditional treatment of diabetic foot is amputated, which not only affects the patient's quality of life, but also to the
society and the increased burden on the patient's household, the majority of patients and their families are reluctant to accept.
With advances in technology, a new type of vessel suitable for small legs balloon and guide wire in the international community was born, so that diabetic
foot such as peripheral vascular disease, interventional treatment become a reality. But due to technical conditions and other factors limit the ability of
domestic clinical hospital to carry out this technology are still rather scarce. Jinan Central Hospital, Qing-Yi Meng, director of Vascular Surgery, is the
early study of this new technology, experts in the field, in the three-year exploration, is now a very mature manner with the treatment of diabetic foot and
lower limb arteriosclerosis obliterans, and to achieve better results. To this end, the author interviewed Jinan Central Hospital, Qing-Yi Meng, director of
vascular surgery.
Four symptoms to arouse your attention
Diabetes is a chronic disease in the modern top three killers. Diabetes itself is the most horrible complications, including diabetic foot is a more serious
complication of diabetes, is one of leading causes of disability in patients with diabetes mellitus.
According to Director Meng introduced a very high incidence of diabetic foot, gangrene chance occurrence much higher than the common people. As a long-term
high glucose status, and other factors, such as obesity, high blood lipids, hypertension, smoking, etc., leading to the body's large and small blood vessels,
nerves, tendons, fascia and other organizations lesions, the organization of metabolic disorders foot, cycle , nutrition disorder, feeling sluggish or lose,
easy to injury or bacterial, fungal and other infections, the formation of diabetic foot gangrene. It is also prone to diabetes foot damage and gangrene of
the main reasons.
Director Meng reminded diabetes, four symptoms must be brought to your attention: First, feeling cold lower extremity fat, numbness, leg muscle spasms occur,
that is, we say that the cramps, the symptoms are often mistaken calcium deficiency and the elderly ignored; 2 after exercise, there is pain, such as walking
distance resulting from spastic pain and had to take a break, and then walk some distance from the recurrence of pain, pain in lower legs, followed by the
buttocks, thighs, back, foot, etc. parts; 3, skin color changes, especially the night in pain, falls or minor physical activity, reducing pain may have
occurred more serious blood vessel disease, should be timely medical treatment, or the further development will enter a period of necrosis; 4, tissue
ischemia and necrosis, common skin, malnutrition, muscle atrophy, rough skin, worse, sparse fine hair, or expulsion; toe (referring to) A slow-growing,
thicker and less shiny, has a slight broken foot is not easy to heal seriously ill, the will appear black limbs infected necrosis.
Diabetic foot disease is a peripheral neuropathy (including autonomic neuropathy), major vascular disease and poor foot health and many other complex
interactions between factors caused. The size of the role of each factor varies, because of its consequences lead to lower limb amputation, and therefore one
of the most feared complication of diabetes.
Compared with the general population, diabetic patients with lower limb amputation than 15-40 times more likely to be. In the elderly at higher risk.
However, if the active treatment, the majority of amputations can be avoided.
Minimally invasive treatment of diabetic foot to open up new ways of
According to Qing-Yi Meng, director of introduction, the incidence of diabetic foot is due to the accumulation of the inner walls of blood vessels of many
different sizes of lipid plaque, allowing blood vessels to small cavity through a small quantity of blood, limbs, especially the end of the toe or a leg
because of a lack of blood the supply of metabolic disorder arising from a gradual degeneration, necrosis, has always been one of the diseases clinically
difficult, the traditional medicine to use more conservative treatment methods, advanced surgical amputation, patients often need to give patients a huge
mental and physical suffering.
With the continuous deepening of medical research, especially in recent years, the rapid development of interventional therapy, so that the treatment of this
chronic disease breakthrough has been made. Jinan Central Hospital vascular surgery using interventional arterial angioplasty is the treatment of diabetic
foot international advanced technology, one of the basic principles of percutaneous minimally invasive technique is used on a dedicated guide wire under the
guidance will be a tiny balloon into a special stenosis or occlusion of blood vessels within the lesion, paragraph by paragraph exploration, dredging, and
repeatedly expanding, which causes blood vessels to re-open and restore blood flow, improve the blood supply to the remote limb. Simply put, that is the root
of the thigh puncture, puncture point from this into a special hair-thin guide wire and catheter, the guidewire along the femoral artery in the imaging
device under the control of in-depth of the lesion had been narrow or even block blood vessels, and then use imaging agent so that the full balloon
expansion, softened lesions, vascular lesion expansion stereotypes in order to restore normal blood flow.
This therapeutic use of local anesthesia, surgery, the patient remains awake state, compared with other anesthesia, local anesthesia side effects is
relatively small. Therefore, not only for interventional approach in patients with relatively good physical condition, more adapted to the elderly, the
infirm, and other organ disorders.
This treatment method is invasive, quick, high rate of limb salvage in patients with obvious advantages for the treatment of diabetic foot has opened a new
way.
According to Director Meng introduction, the blood vessels of diabetic foot disease is characterized by wide range of bilateral lesions involving more than
the number of branch arteries, and were more seasonal distribution, bypass surgery and other difficult to deal with a broader range of lesions, but is more
suitable for interventional therapy in patients with . Under normal circumstances, viable suitable percutaneous endovascular thrombolysis, endovascular
balloon angioplasty, vascular stent implantation, laser angioplasty, plaque excision, lower extremity brachytherapy, after Paper mechanical thrombectomy, so
as to maintain the patency of blood vessels, essentially for therapeutic purposes.
Interventional treatment of diabetic foot, from the causes to resolve the lower extremities caused by diabetes, vascular disease, rapid resumption of blood
supply, to address the neurological disease, treatment of infections, so that ulcer healing, and create a foundation, thus unable to completely get rid of
the traditional treatment of the situation. At present, the Jinan Central Hospital vascular surgery through minimally invasive interventional treatment
professional can be the entire lower extremity, including the most remote of the foot of the small blood vessels open up, so that lower limb blood flow from
top to bottom completely. Limb salvage rate than in the past has greatly improved with advanced diabetic foot to bring the gospel.
According to Director Meng say, in addition to diabetic foot, the result from atherosclerosis of the iliac artery, femoral artery, renal artery, lower
extremity arterial stenosis, peripheral vascular disease, can also be obtained through the satisfactory efficacy of interventional therapy.
Prevention of diabetic foot larger than the rule
According to Director Meng said that diabetes patients need to take some precautionary measures to avoid the complicated diabetic foot, in particular, to
note the following points:
Eat less fatty and sugar foods that are high. Strict control of blood sugar, blood sugar is too high to avoid the prevention and treatment of diabetic foot a
very important part, which helps prevent and delay diabetes complications.
Prohibition of smoking, more moderate campaign to improve microcirculation. To promote blood circulation to the feet to do more exercise, the best is a
moderate movement, such as walking or leg exercise. Appropriate exercise can improve microcirculation, promote metabolism, enhance the body's insulin
sensitivity, increase muscle glucose utilization and organizations to achieve the purpose of prevention of diabetic foot.
Active steps to prevent foot injuries is to prevent the occurrence of foot ulcers are the most fundamental way, diabetes patients must be taken to avoid any
slight foot injury. Do not walk barefoot to prevent the stabbing; do not wear footwear sub-feet should be soft, comfortable, breathable and good; do not have
hot water their feet or their feet or 10-15 minutes a day with warm water, using hot water bottle or a foot note of this when physical therapy temperature
and time; all but cut toenails; without losing sight of tinea pedis infection, prompt treatment of tinea pedis paronychia; if injured foot, and early
treatment to avoid amputation priority.
Maintenance foot skin integrity and clean, also to protect the diabetic patients, diabetic foot away from the points. Diabetic patients should be self-
examination and soles of the feet before going to sleep every night, if the elderly due to physical reasons, difficult to see the soles of the feet of
musicians, you can put a mirror placed at the feet, observing the mirror reflects the feet, such as the patient was found feet have any problems, such as
ulceration, corpus callosum (cocoon the child), corns, skin dry, damp and cool, edema, skin darkening, sensory loss, nail deformation, localized swelling and
pain, fever and so on, must be as soon as possible to the hospital for treatment, not to dispose of their own. Any diabetic foot problems should be cautious,
otherwise serious consequences.
Finally, the Director Meng reminded the event of a diabetic lower limb weakness, foot back significantly decreased arterial pulse and other symptoms, its
lower extremity blood vessels occurred at least 70% stenosis; when there is pain, numbness and other symptoms Suanzhang narrow even more weight; When foot
ulceration, the amputees will face consequences. Thus, diabetic patients should insist on rational use of medicines control the disease at the same time, pay
close attention to lower extremity, particularly the feet, once the abnormal early detection, the sooner the better receiving interventional treatment.
