细菌感染对糖尿病足治疗及预后的影响  

The Influence of Multidrug Resistance Bacteria Infection on Curative Effect and Prognosis in Patients With Diabetic Foot

作　　者：肖正华[1] 周倩[1] 陈定宇[1] 余绮玲[1] 周峥[1] 黄春苓[1] 叶林[1] 徐琳[1] 

机构地区：[1]广东省广州市第一人民医院内分泌科,510180

出　　处：《实用全科医学》2006年第1期37-38,共2页Applied Journal Of General Practice

摘　　要：目的探讨细菌感染及多药耐药对糖尿病足部溃疡疗效及预后的影响。方法回顾468例糖尿病足患者足部溃疡细菌培养及药物敏感试验结果结合溃疡病变的程度、性质及治疗过程中溃疡处肉芽出现时间(GT)、溃疡愈合时间(HT)进行综合分析。结果①糖尿病足部溃疡多为2种或2种以上细菌的混合感染,多药耐药率较高;②I级溃疡细菌感染以革兰阳性球菌和肠球菌为主,且以1种细菌单独感染为多,II^V级溃疡患者则以多种细菌混合感染为多,多药耐药率也较高;③I^II级的溃疡患者其肉芽出现时间和溃疡愈合时间均与其相应的细菌多药耐药性之间无显著的相关关系(均P>0.05),而III及IV、V级湿性坏疽患者其GT和HT则与细菌多药耐药率之间均存在显著的正相关,(均P<0.05);④I^II级溃疡患者的截肢率和病死率与其相应的细菌多药耐药率间均无显著的相关关系(P>0.05);III至IV级的溃疡患者其截肢率与其相应的细菌多药耐药率有显著的正相关(均P<0.05)。结论细菌感染及其多药耐药可影响溃疡程度、疗效和预后。Objective To inquire into the influence of multidrug - resistant bacteria infection on diabetic toot. Methods In 468 patients with diabetic foot （DF）, drug sensitive test of bacteria cultured from secretions or necrotic tissue of, the time of granulation arising （GT）, the time of healing up （HT）, the amputation rate and mortality were observed after the patients were treated. Results There were two or over two bacteria with multidrug resistance isolated from diabetic foot ulcer. Of them, Gram - positive aerobes were more common in grade Ⅰ DF,mixed infection of two or over two bacteria infection and more multidrug - resistant microbe were much more common in class Ⅱ to Ⅴ DF. The amputation rate and mortality exhibited significantly positive linear correlation with the rate multidrug- resistance bacteria infection in grade Ⅲ to Ⅴ DF. Conclusions The bacteria in- fection and multidrug- resistance bacteria infection affect the course,curative effect and prognosis of DF.

关 键 词：糖尿病足部溃疡 细菌多药耐药性 

分 类 号：R587.2[医药卫生—内分泌]