摘要
目的分析和总结糖尿病足的临床特点和治疗体会。方法回顾性分析2013年6月至2017年8月北京朝阳急诊抢救中心烧伤整形科收治的43例严重糖尿病足患者的临床资料,根据患者截肢(趾)与否,将43例患者分为截肢组、截趾组、截肢(趾)组和非截肢(趾)。对患者年龄、糖尿病病程、住院时间、血浆白蛋白浓度、血红蛋白水平、白细胞计数、糖化血红蛋白水平、血糖值、Wagner分级、有无糖尿病周围神经病变、视网膜病变、糖尿病肾病、坏死性筋膜炎等进行分析。数据进行单因素方差分析、多因素非条件Logistic回归分析、独立样本t检验和χ2检验。结果截肢组患者的住院时间为(80.7±39.3)d,长于非截肢(趾)组(58.4±14.2)d,差异有统计学意义(t=-2.27,P=0.03);截肢(趾)组、截肢组和截趾组的年龄分别为(58.7±9.8)、(55.7±11.2)、(62.2±6.7)岁,与非截肢(趾)组(59.0±8.4)岁相比,差异均无统计学意义(t=0.12、0.96、-1.07,P=0.91、0.35、0.29);截肢(趾)组、截肢组和截趾组的糖尿病病程分别为(13.4±6.4)、(12.3±7.1)、(14.6±5.5)年,较非截肢(趾)组(15.4±6.3)年,差异均无统计学意义(t=1.03、1.29、0.32,P=0.31、0.21、0.75);截肢(趾)组和截肢组的血浆白蛋白浓度均分别为(21.9±3.0)、(20.9±2.4)g/L,明显低于非截肢(趾)组的(25.0±4.5)g/L,差异均有统计学意义(t=2.80、3.04,P=0.01、P<0.05);截肢(趾)组、截肢组和截趾组的血红蛋白水平分别为(93.1±14.2)、(91.8±13.5)、(94.6±15.5)g/L,与非截肢(趾)组(101.4±14.9)g/L相比,差异均无统计学意义(t=1.86、1.85、1.19,P=0.07、0.07、0.25);截肢(趾)组、截肢组和截趾组的白细胞计数分别为(23.1±4.3)、(23.7±4.8)、(22.4±3.9)×109/L,与非截肢(趾)组(21.8±3.6)×109/L相比,差异均无统计学意义(t=-1.08、-1.30、-0.46,P=0.29、0.20、0.65);3组的糖化血红蛋白水平分别为(9.8±1.2)、(10.1±1.3)、(9.6±1.1)mg/dl,与非截肢(趾)组(9.4±1.5)mg/dl相比,差
Objective To analyze and summarize the clinical characteristics and treatment experience of the diabetic foot. Methods The clinical data of 43 patients with severe diabetic foot treated in the department of Burns and Plastic Surgery in Beijing Chaoyang Emergency Medical Center from June 2013 to August 2017 were retrospectively analyzed,and 43 patients were divided into 4 groups： amputation group,cutoff toe group,amputation（ toe） group and non-amputation（ toe） group. The age,duration of diabetes,hospitalization time,serum albumin concentration,hemoglobin level,white blood cell count,glycosylated hemoglobin level,blood glucose level,Wagner grade,with or without diabetic peripheral neuropathy,ocular retinopathy,diabetic nephropathy,necrotizing fasciitis of patients in 4 groups were analyzed. The data were analyzed by one-way ANOVA,multivariate non-conditional Logistic regression analysis,independent sample t-test and chi-square test. Results The hospitalization time of patients in amputation group was（ 80. 7 ±39. 3） d,it was longer than that in non-amputation（ toe） group＇ s（ 58. 4 ± 14. 2） d,the difference was statistically significant（ t =-2. 27,P = 0. 03）; the age of patients in amputation（ toe） group,amputation group and cutoff toe group were（ 58. 7 ± 9. 8）,（ 55. 7 ± 11. 2） and（ 62. 2 ± 6. 7） years,compared with the non-amputation（ toe） group＇ s（ 59. 0 ± 8. 4） years,there were no statistically significant differences（ t = 0. 12,0. 96,-1. 07,P = 0. 91,0. 35,0. 29）. The duration of diabetes was（ 13. 4 ± 6. 4）,（ 12. 3 ± 7. 1）,and（ 14. 6 ± 5. 5） years in the amputation（ toe） group,the amputation group and the cutoff toe group,which were significantly higher than that in the non-amputated（ toe） group＇ s（ 15. 4 ±6. 3） years,the differences were not statistically significant（ t = 1. 03,1. 29,0. 32,P = 0. 31,0. 21,0. 75）. The plasma albumin concentrations in amputation（ toe） group and amputation group were（ 21. 9 ±3.
作者
王娟
张兵钱
孙志刚
范宝玉
王庆伟
Wang Juan;Zhang Bingqian;Sun Zhigang;Fan Baoyu;Wang Qingwei(Department of Burns and Plastic Surgery, Beijing Chaoyang Emergency Medical Center, Beifing 100122, China;Chongqing Medical and Pharmaceutical College, Chongqing 401331, China)
出处
《中华损伤与修复杂志（电子版）》
CAS
2018年第1期37-42,共6页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
关键词
糖尿病足
感染
综合疗法
截肢
截趾
Diabetic foot
Infection
Combined modality therapy
Amputation
Toe amputation
