糖尿病足溃疡转归相关因素的分析  

Research on predictors of wound healing rate of diabetic foot

作　　者：郝兆虎[1] 王鹏华[1] 褚月颉[1] 李雪梅[1] 郑志魁[1] 逯海波[1] 丁群[1] 孟树优[1] 

机构地区：[1]天津医科大学代谢病医院足病科,卫生部及天津市激素与发育重点实验室,300070

出　　处：《中国糖尿病杂志》2010年第4期284-287,共4页Chinese Journal of Diabetes

摘　　要：目的研究糖尿病足溃疡的愈合,并对影响因素进行相关分析。方法回顾性研究2008年1月至11月我科住院治疗的106例糖尿病足溃疡患者愈合情况及其影响因素。结果患者年龄、贫血、溃疡深度、感染、骨髓炎、糖尿病外周神经病变、坏疽和血流灌注是影响愈合的危险因素(P均<0.05)。回归分析示骨髓炎、血流灌注、坏疽是影响愈合的独立危险因素。对不存在坏疽、骨髓炎和缺血的27例患者溃疡愈合情况研究发现,合并感染的溃疡愈合时间显著延长(P<0.05)。结论无论溃疡是否缺血,感染均是影响溃疡愈合的重要因素,及时就诊可以减少坏疽或骨髓炎的发生。Objective To study outcome of diabetic foot ulcers and to seek its association with features of the ulcers. Methods Data collected retrospectively were analyzed in a consecutive cohort of 106 patients referred to our hospital between January and November in 2008. A single index ulcer was classified according to potential factors, including age, sex, BMI, duration of diabetes mellitus, duration of diabetic foot, ulcer area, depth, infection, perfusion, osteomyelitis, gangrene and co-morbidities. The relationship between the outcome and the factors was analyzed. Results Diabetic foot showed healing in 71 Case,among whom 13 had minor amputation, and unhealing in 35 cases, among whom 5 had major amputation. Age,anemia, depth, infection,osteomyelitis, DPN, gangrene and perfusion were all univariate predictors. In logistic regression analysis, osteomyelitis, gangrene and perfusion were independent predictors of healing failure. In the study of 27 patients without osteomyelitis, gangrene or ischemia, infected ulcers needed more time to heal （P〈0.05）. Conclusions Whether ulcers are ischemic or not, infection is an important influential factor. When ulcers are treated in time, ostemoyelitis or gangrene occurs less.

关 键 词：糖尿病足 溃疡 创面愈合 影响因素 

分 类 号：R587.2[医药卫生—内分泌]