Clinical Study Of Indocyanine Green Angiography In Diabetic Peripheral Blood Vessels

Objective: To explore the role of indocyanine green angiography in the detection of peripheral vascular lesions of diabetes feet,and try to use its imaging features to guide the debridement of patients with diabetes foot ulcer during operation,so as to provide a new idea for the detection of peripheral vascular lesions of diabetes feet and the debridement of diabetes foot ulcer.Methods: 60 patients with diabetes foot who were treated in the Department of burn and plastic surgery of Xi’an Central Hospital from December 2019 to December 2021 were selected as the research objects.According to Wagner’s classification,they were divided into gangrene group and non gangrene group.The basic information of the patients was collected.Digital subtraction angiography(DSA)and indocyanine green angiography(ICGA)were used to analyze the medial plantar artery The lateral plantar artery,dorsalis pedis artery and arcuate artery were detected.The results of ICGA were compared with those of DSA to evaluate the sensitivity,specificity and accuracy of ICGA in gangrene group and non gangrene group.According to Wagner’s grading,diabetes foot patients with grade 2 were selected and divided into experimental group and control group according to the method of randomized controlled experiment.patients in the experimental group were routinely tested with ICGA before debridement,to preserve the ecological tissues with good blood circulation and to remove the necrotic tissues with insufficient ICGA perfusion;The control group relied on the subjective judgment of clinicians to remove necrotic tissue.Image J software was used to record the wound area before debridement and 2 weeks after debridement.The healing time,dressing changes,hospital stay and clinical efficacy of limb ulcer in the experimental group and the control group were compared.The clinical significance of ICGA angiography in guiding the debridement of diabetes feet was observed.Results: 1.ICGA showed higher sensitivity,specificity and accuracy in the detection of peripheral blood vessels in patients with diabetes foot,especially in the non gangrene group.2.ICGA showed a good reference and guidance role in diabetes foot debridement.After using ICGA to guide Wagner type 2 patients to treat the wound,the healing speed was significantly faster than that of the control group(p > 0.05,no significant statistical significance).The number of dressing changes in the ICGA group was less than that in the control group(p > 0.05);In terms of cure time and hospital stay,ICGA group was relatively shorter(p value greater than 0.05,no significant statistical significance);In the clinical effect,the ICGA group was significantly better than the control group(p value greater than0.05,no significant statistical significance).Conclusion:1.ICGA can play a good auxiliary role in the detection of peripheral blood vessels in diabetic foot patients.It has high sensitivity,specificity and accuracy,and can be used as an economical,simple,safe and effective imaging method.2.ICGA plays a good guiding and assisting role in debridement of Wagner2 type 2 diabetic foot patients.