
豐原醫院血管外科主任張耀中表示,糖尿病、長期吸菸及心血管疾病者若出現走路腿痛、腳冷、膚色改變或傷口超過兩週未癒、腳趾發黑等症狀,應儘早就醫,以避免小傷惡化導致截趾或截肢,並分享一名71歲糖尿病患者經動脈繞道手術保住最後一條腿的案例。
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周邊動脈阻塞是糖尿病及長期吸菸者常見併發症,若不及時治療可能導致組織壞死及截肢。豐原醫院提供血管超音波、血管攝影檢查及動脈繞道手術等完整治療鏈,符合健保給付標準。
2026/10/05 12:07
豐原醫院血管外科主任張耀中表示,糖尿病、長期吸菸及有心血管疾病者,若出現走路一段距離就腿痠痛、腳部冰冷或膚色改變,以及傷口超過兩週仍未改善、腳趾逐漸發黑等情況,應儘早就醫。(豐原醫院提供)
〔記者歐素美/台中報導〕 一名71歲劉姓老翁左腿已因血管疾病膝下截肢,右腳也陸續截除4根腳趾,只剩大拇趾,僅存右腿又因大腿到膝蓋以下多處重要血管嚴重阻塞,導致足部傷口遲遲無法癒合,面臨截肢危機,急至衛生福利部豐原醫院血管外科就醫,醫療團隊進行長達5小時的下肢動脈繞道手術,重新建立血流,術後右腳傷口恢復紅潤,才保住「最後一條腿」。
豐原醫院血管外科主任張耀中表示,劉翁罹患糖尿病多年,又有長達50年的吸菸史,右側大腿主要動脈阻塞,就連膝蓋以下供應足部的3條主要血管也嚴重阻塞,等於「通往右腳的主要道路幾乎都塞住」,醫療團隊採取動脈繞道手術,就像另外開闢一條道路,讓血液繞過阻塞處重新流向腳部,需吻合的血管直徑僅約0.1公分,縫合難度高,最終歷經約5小時完成血管重建,術後腿部血流恢復暢通,劉男10天後順利出院,並搭配高壓氧治療、持續門診追蹤。
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張耀中指出,因慢性動脈阻塞接受膝下等重大截肢的患者,5年死亡率約40%至70%,這類患者往往還伴隨全身性血管硬化、心血管疾病或腎功能不全,尤其劉男左腿已截肢,右腳只剩大拇趾,若再失去右腿,行動及生活自理能力都將受到重大影響,因此治療不只是把血管打通,更希望保留病人的肢體與生活功能。
張耀中指出,針對周邊動脈阻塞、糖尿病足合併缺血等疾病,豐原醫院可透過血管超音波、血管攝影找出阻塞位置,再依病況評估動脈繞道手術等治療,從檢查、評估到手術皆可在院內完成,相關治療依健保規定給付,讓中部山城地區患者能就近接受治療,把握保肢時機。
張耀中提醒民眾,腳傷一直好不了,有時不只是傷口問題,而可能是「血送不到腳」。糖尿病、長期吸菸及有心血管疾病者,若出現走路一段距離就腿痠痛、腳部冰冷或膚色改變,以及傷口超過兩週仍未改善、腳趾逐漸發黑等情況,應儘早就醫評估血管狀況,避免小傷口一路惡化到截趾甚至截肢。
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