糖尿病足复发感染90例临床特点及危险因素分析  

Clinical features and risk factors of 90 patients with diabetic foot recurrent infection

作　　者：吴旭红[1] 廖立新[1] 潘实[1] 康春福 Wu Xuhong;Liao Lixin;Pan Shi;Kang Chunfu(Department of Burns and Plastic Surgery, the First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361000, China)

机构地区：[1]厦门大学附属第一医院整形美容烧伤科,361000

出　　处：《中国基层医药》2019年第10期1217-1220,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的通过分析糖尿病足感染患者的临床资料,探讨糖尿病足复发感染的临床特征及相关危险因素。方法选择2014年1月至2017年12月厦门大学附属第一医院整形美容烧伤科收治的糖尿病足感染患者158例为研究对象,其中90例糖尿病足复发感染者,行常规细菌培养,对比分析复发感染与非复发感染患者临床资料,多因素logistic回归分析糖尿病足复发感染相关危险因素。结果90例糖尿病足复发感染者培养108株病原菌,其中革兰阳性菌(G+)、革兰阴性菌(G-)、其他病原菌分别占54.63%(59株)、39.81%(43株)、5.56%(6株),糖尿病足复发感染与非复发感染患者在病程、年龄、白细胞计数、血红蛋白、纤维蛋白原、白蛋白水平及Wanger分级4~5级比例、双下肢周围血管病变、近期使用抗菌药物、溃疡愈合时间比较,差异均有统计学意义(t=6.003、6.132、3.144、4.322、4.513、11.179、7.164,χ^2=4.269、8.613、25.083、23.298,均P<0.05),多因素分析显示糖尿病足复发感染独立危险因素为双下肢周围血管病变、近期使用抗菌药物、溃疡愈合时间≥65 d(χ^2=5.134,4.807,10.512,均P<0.05)。结论溃疡愈合时间≥65 d、双下肢周围血管病变、近期使用抗菌药物的糖尿病足患者复发感染的风险较高,应密切观察,依据患者自身情况早期采取预防措施。Objective To investigate the clinical features and risk factors of diabetic foot recurrence infection in diabetes mellitus (DM) patients. Methods A total of 158 patients with diabetic foot infection from January 2014 to December 2017 admitted to the First Affiliated Hospital of Xiamen University were selected in the study.There were 90 patients with diabetic foot recurrence.The clinical data of patients with recurrent infection and non-recurrent infection were compared and analyzed.Multivariate logistic regression was used to analyze the risk factors associated with recurrent infection of diabetic foot. Results Ninety patients with recurrent infection of diabetic foot were cultured with 108 strains of pathogens, of which Gram-positive(G+), Gram-negative(G-), and other pathogens accounted for 54.63%(59 strains), 39.81%(43 strains), 5.56%(6 strains), respectively.The differences in disease duration, age, white blood cell count, hs-CRP, hemoglobin, fibrinogen, albumin levels, and Wanger grade 4 to 5 ratio, peripheral vascular lesions of the lower extremities, recent use of antibiotics and the healing time of ulcers in patients of diabetic foot recurrence and non-recurrent infections were statistically significant(t=6.003, 6.132, 3.144, 4.322, 4.513, 11.179, 7.164,χ^2=4.269, 8.613, 25.083, 23.298, all P<0.05). Multivariate analysis showed that the independent risk factors for diabetic foot recurrence were peripheral vascular lesions of the lower extremities, recent use of antimicrobial agents, ulcer healing time more than 65 days(χ^2=5.134, 4.807, 10.512, all P<0.05). Conclusion The results show that patients with ulcer healing time more than 65 days, vascular lesions around the lower extremities, and diabetic foot who recently used antibiotics have a higher risk of recurrent infections.Close observation should be made to take early precautionary measures based on the patients' own condition.

关 键 词：糖尿病足 复发 危险因素 外周血管疾病 抗感染药 伤口愈合 

分 类 号：R587.2[医药卫生—内分泌]