WIFi分级用于预测糖尿病足合并周围血管病变病人下肢血管再通后伤口愈合效果研究  

Clinical application of WIFi classification system on the wound healing of diabetic foot patients with lower limb ischemia after lower limbs re-vascularization

作　　者：汪涛[1] 赵珺[1] 梅家才[1] 邵明哲[1] 潘烨[1] 张健[1] 吴海生[1] 于敏[1] 杨文超[1] 

机构地区：[1]上海交通大学附属第六人民医院血管外科,上海200233

出　　处：《中国实用外科杂志》2016年第12期1293-1297,共5页Chinese Journal of Practical Surgery

摘　　要：目的探讨2014年美国血管外科协会颁布的WIFi分级用于预测糖尿病足合并周围血管病变病人下肢血管再通后的伤口愈合效果评价的临床意义。方法 2013年1月至2016年1月,上海交通大学附属第六人民医院对109例糖尿病足合并周围血管病变病人行下肢血管再通成功,根据伤口愈合结果分为伤口愈合组(n=64)和未愈合组(对照组,n=45);分析两组临床资料和WIFi分级情况,并通过单因素、多因素和Logistic回归分析总结糖尿病足合并血管病变病人行下肢血管再通后伤口愈合的独立危险因素。结果两组病人年龄、性别、踝肱指数(ABI)、血白蛋白、总胆固醇(TC)、饮酒史、吸烟史、糖化血红蛋白(HbA1c)、创面大小、发生溃疡时间、空腹血糖、糖尿病病程以及心脑血管合并疾病比例差异均无统计学意义(P>0.05),单因素分析提示WIFi分级中的创面分级(W)和缺血分级(I)在伤口愈合中具有预测意义(P<0.01)。多因素回归分析中创面等级和下肢缺血程度是延缓血管再通后伤口愈合时间的危险因素(P<0.01)。二元Logistic回归显示WIFi分级中的I分级是预测血管再通后影响伤口愈合的独立危险因素(P<0.01)。结论 WIFi分级对糖尿病合并周围血管病变病人血管再通后预测伤口愈合情况具有较好的预测和评估价值。Objective To evaluate clinical significance of WIFi classification issued by American Society for Vascular Surgery in 2014, predict the effectiveness of revascularization for diabetic foot patients with peripheral vascular disease. Methods The total of 109 diabetic foot patients with peripheral artery disease successfully conducted re-vascularization between January 2013 and January 2016 in Affiliated Sixth People＇ s Hospital, Shanghai Jiao Tong University were divided into two groups. Sixty-four patients whose wound healed successfully were set into observation group, while forty-five patients with non-healing wound as the controlled group. Clinical data, WIFi classification of those patients were analyzed retrospectively. The high risk factors of wound healing were analyzed by single factor, multiple factor and Logistic regression analysis. Results There was no significant difference in clinical data such as age, gender, ABI, HbAlc,TC, blood glucose,the course of diabetes and ratio of cardiovascular and cerebrovaseular diseases between the two group （P〉0.05）. Single factor regression analysis showed that there was significant difference between two groups in the W and I classification system （P〈0.01）. Multiple factors regression analysis indicated that wound and ischemia grade were independent risk factors of wound healing time after re-vascularization. Logistic regression analysis displayed that serious I grade in the WIFi classification system was predictive independent risk factors of wound healing time after re-vascularization （P〈0.01）. Conclusion Using WIFi classification system to evaluate the risk of wound healing after re-vascularization among diabetic foot patients with peripheral artery disease has a better prediction and evaluation value.

关 键 词：WIFi分级 糖尿病足 周围血管病变 再血管化 伤口愈合 

分 类 号：R6[医药卫生—外科学]