影响糖尿病下肢溃疡愈合的危险因素分析  

Analysis of risk factors affecting the cicatrization of diabetic lower extremity ulcers

作　　者：甄庆强 陈克军 赵志强 王玉涛 孙岩 ZHEN Qingqiang;CHEN Kejun;ZHAO Zhiqiang(Department of Hepatobiliary and Vascular Surgery,Jinan City People's Hospital,Shandong,Jinan 271100,China)

机构地区：[1]济南市人民医院肝胆血管外科,271100 [2]济南市钢城区辛庄中心卫生院内科 [3]济南市中医医院周围血管病科 [4]山东第一医科大学附属省立医院血管外科

出　　处：《临床外科杂志》2020年第6期518-521,共4页Journal of Clinical Surgery

基　　金：山东省中医药科技发展计划资助项目(2019-0303、2017-299);山东省医药卫生科技发展计划资助项目(2018WS478、2018WS273);济南市第二届优秀卫生计生人才培养资助项目(济卫科外发[2018]8号);济南市第三批“薪火传承231工程”培养资助项目(济中医药发[2017]11号);济南市卫生健康系统青年岗位能手培养项目(济卫发[2019]1号);济南市卫生健康委员会科技计划资助项目(2019-1-23)。

摘　　要：目的探讨影响糖尿病下肢溃疡(diabetic lower extremity ulcers,DLEU)愈合的危险因素。方法回顾性分析2015年7月至2018年7月山东第一医科大学附属省立医院、济南市中医医院和济南市人民医院收治的DLEU病人95例,根据随访期内溃疡是否愈合分为愈合组(45例)和未愈合(50例),运用logistic回归分析影响DLEU愈合的独立危险因素。结果两组病人在性别、年龄、糖化血红蛋白、体质量指数、DLEU病程、糖尿病病程、高血压病史、手术方式、术前踝肱压力指数(ankle brachial index,ABI)和术前疼痛视觉模拟评分(visual analogue score,VAS)等方面差异无统计学意义(P>0.05)。而在冠心病病史、术后ABI、溃疡部位等方面差异有统计学意义(P<0.05)。Logistic回归显示,冠心病病史、术后ABI、溃疡部位为影响DLEU愈合的独立危险因素。结论合并冠心病、低于正常水平的ABI、足趾、足底、足背和胫前区等溃疡部位是影响DLEU愈合的独立危险因素。Objective To investigate the risk factors affecting the healing of diabetic lower extremity ulcers(DLEU).Methods Clinical data of 95 patients with DLEU treated in Provincial Hospital Affiliated to Shandong First Medical University,Jinan Municipal Hospital of Traditional Chinese Medicine and Jinan People’s Hospital from July 2015 to July 2018 were retrospectively analyzed.According to whether the ulcer cicatrized during the follow-up period,patients were divided into the healing group(45 cases)and unhealing group(50 cases),independent risk factors affecting DLEU healing were analyzed using logistic regression analysis.Results There was no significant difference in sex,age,glycosylated hemoglobin,body mass index,DLEU course,diabetes course,history of hypertension,operation mode,preoperative ankle brachial pressure index(ABI)and preoperative visual analogue score(VAS)between the two groups(P>0.05).However,the difference in the history of coronary heart disease,postoperative ABI,ulcer site and so on were statistically significant(P<0.05).Logistic regression showed that the history of coronary heart disease,postoperative ABI and ulcer site were independent risk factors for DLEU healing.Conclusion Coronary heart disease,subnormal ABI and ulcer sites such as toe,acrotarsium,pelma and pretibial are independent risk factors for DLEU healing.

关 键 词：糖尿病下肢溃疡 愈合 危险因素 

分 类 号：R658.3[医药卫生—外科学] R587.2[医药卫生—临床医学]