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作 者:林红[1] 汪小清 黄丽辉[1] 徐敏丹[1] 马琳[1] 赖人旭[3]
机构地区:[1]中山大学附属第五医院干部保健科,广东珠海519000 [2]中山大学附属第五医院预防保健科,广东珠海519000 [3]中山大学附属第五医院消化科,广东珠海519000
出 处:《中国感染与化疗杂志》2017年第1期14-18,共5页Chinese Journal of Infection and Chemotherapy
摘 要:目的探讨糖尿病足部溃疡感染病原菌的特点以及相关危险因素,并针对相关因素提出预防及干预措施,以促进患者早日康复。方法回顾性分析2012年2月至2014年5月治疗的120例糖尿病足患者临床资料,将发生糖尿病足部溃疡感染的38例患者作为感染组,未发生溃疡感染的82例患者作为非感染组,分析糖尿病足部溃疡感染的病原菌特点和影响感染相关危险因素。结果该研究38例感染患者中共分离出病原菌43株,革兰阳性菌22株,占51.2%;革兰阴性菌18株,占41.9%;真菌3株,占7.0%。位居前3的病原菌为金黄色葡萄球菌、铜绿假单胞菌和阴沟肠杆菌,均为7株,各占16.3%。单因素分析结果显示,合并糖尿病血管并发症、合并视网膜病变、溃疡数目>2个、合并骨髓炎以及合并肾病等与感染密切相关(P<0.05);多因素分析结果显示,高密度脂蛋白胆固醇、血红蛋白、糖尿病血管并发症以及溃疡数目、骨髓炎是糖尿病足部溃疡感染的独立危险因素。结论糖尿病足部溃疡感染是多种因素共同作用而致,因此临床应加强对这些因素的预防和控制,以降低糖尿病足部溃疡的感染率。Objective To explore and analyze the pathogen profile and risk factors of infected diabetic foot ulcers, and propose appropriate prevention and intervention measures for early recovery of patients. Methods The data of 120 patients with diabetic foot ulcers treated in our hospital from February 2012 to May 2014 were retrospectively analyzed. These patients were classified into infection group (38 patients) and non-infection group (82 patients) based on whether their ulcer was infected or not. The pathogens and risk factors of infection in diabetic foot ulcer were analyzed. Results In this study, 43 strains of pathogenic bacteria were isolated from 38 cases of infection, of which gram positive bacteria accounted for 51.2 %, gram negative bacteria 41.9 %, and fungi 7.0%. Staphylococcus aureus, Pseudomonas aeruginosa and Enterobacter cloacae were the top three pathogens, accounting for 16.3 % each. Univariate analysis showed that diabetic vascular complication, retinopathy, more than 2 foci of ulcer, osteomyelitis, and diabetic nephropathy were closely associated with infection (P〈0.05). Multivariate logistic regression analysis showed that HDL-C, albumin, diabetic vascular complication, number of ulcers, osteomyelitis were independent risk factors for infection in patients with diabetic foot ulcer. Conclusions HDL-C, red blood cell, hemoglobin, diabetic complications, white blood cell, triglyeeride, albumin, diabetic vascular complication and smoking are the risk factors for infection in patients with diabetic foot ulcer. These factors should be prevented and controlled to reduce the incidence of infection in diabetic foot ulcer.
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