摘要
糖尿病足部溃疡是糖尿病的一个严重并发症,占非创伤性截肢的第1位。糖尿病足发病涉及足踝外科、血管外科、内分泌科、感染控制,治疗方案需多学科联合诊治。清创术是治疗糖尿病足部溃疡的基础,清创过程中须注意维持足部正常解剖结构;负压封闭引流技术以及抗生素骨水泥在外科感染控制、溃烂创面愈合方面优势明显,疗效满意;肌腱延长术可缓解足底部应力集中导致的溃疡发生、进展等,其适应证广泛,优势在于既可预防足部溃疡形成也可治疗溃疡;皮瓣移植虽可以解决创口愈合问题,但是需要考虑移植皮瓣能否承担与足底组织相同的功能;胫骨骨搬运是一项较新的技术,具体机制还不清楚,但从临床疗效看具有一定的应用前景。
Diabetic foot ulcers(DFUs)is a severe complication of the diabetes mellitus,which is the first leading cause of non-traumatic lower limbs amputations.The pathogenesis of diabetic foot involves a variety of mechanisms,treatment involves the department of foot and ankle surgery,department of vascular surgery,endocrinology,and infection control.Treatment need multidisciplinary diagnosis and treatment.Debridement is the basis of treating diabetic foot ulcers,and the normal anatomical structure should be maintained during the process.Vacuum sealing drainage(VSD)and antibiotic-laden bone cement(ALBC)have more advantages of controlling infection and ulceration wound healing,which could receive good clinical effect.Tendon lengthening could alleviate the problem of ulcer occurrence and progression caused by stress concentration on the bottom of foot,which has widely application and has advantages of preventing formation of foot ulcers.Flap transplantation could solve the problem of wound healing,but it is necessary to consider whether the transplanted flap could bear the same function as plantar tissue.Tibial bone transverse distraction is a relatively new technique,and the mechanism is not clear,but it has certain application prospects from the perspective of clinical efficacy.
作者
李桥
胡飞剑
聂静
祖罡
毕大卫
LI Qiao;HU Fei-jian;NIE Jing;ZU Gang;BI Da-wei(Department of Orthopaedics,the Second Affiliated Hospital International Medical Center of Zhejiang University,Hangzhou 311215,Zhejiang,China;不详)
出处
《中国骨伤》
CAS
CSCD
2020年第10期986-990,共5页
China Journal of Orthopaedics and Traumatology
关键词
糖尿病足
溃疡
外科手术
综述
Diabetic foot
Ulcer
Surgical procedures,operative
Review
