海南地区糖尿病足坏疽的风险因素分析  

Risk factors analysis of diabetic foot gangrene in Hainan region

作　　者：麦惠盈 张德昊 潘南芳[1] 覃颖鲜[1] 宋菲菲 王欣[1] 梁萍 王清华[1,3] 郭洪花 MAI Huiying;ZHANG Dehao;PAN Nanfang;QIN Yingxian;SONG Feifei;WANG Xin;LIANG Ping;GUO Honghua;WANG Qinghua(Hainan General Hospital,Haikou,Hainan 570311,China;Hainan Medical University,Haikou,Hainan 571199,China;The Fifth People's Hospital of Hainan Province,Haikou,Hainan 570206,China)

机构地区：[1]海南省人民医院,海南海口570311 [2]海南医学院,海南海口571199 [3]海南省第五人民医院,海南海口570206

出　　处：《中国热带医学》2024年第5期584-590,共7页China Tropical Medicine

基　　金：海南省卫生健康行业科研项目(No.21A200249)。

摘　　要：目的基于糖尿病足是海南地区最常见慢性创面类型,旨在明确海南糖尿病足患者的严重程度和糖尿病足坏疽的风险因素,为降低糖尿病足患者的截肢发生率提供科学依据。方法研究采用现况调查设计,于2022年7月—2023年6月对海南省11个市县19家医院就诊的457名糖尿病足患者进行深入调查。收集的数据包括人口学特征、糖尿病及糖尿病足相关信息等。计数资料采用频数与百分比描述,组间差异比较采用χ^(2)检验,采用二项logistic回归多因素分析并在回归中设置2组递增模型以检验潜在混杂因素对结果的影响。结果海南地区糖尿病足患者中坏疽发生的占比为56.01%(95%CI:51.21%~61.49%)高于其他地区。单因素分析结果显示,年龄、行为习惯、药物治疗、合并症/并发症、家族史和创面细菌感染情况等因素与发生糖尿病足坏疽的风险相关。多因素logistic回归分析结果进一步确认,未接受糖尿病药物治疗、有糖尿病合并症/并发症、未每日检查双足等是糖尿病足坏疽发生的独立风险因素。亚组分析中未发现性别与上述因素之间有显著的交互作用。结论海南地区糖尿病足患者中发生坏疽的占比高于其他地区,发生的风险因素与缺乏规范、及时的救治和患者对糖尿病和糖尿病足的知识缺乏有关,建议加快基层医院创面治疗中心建设,提升糖尿病足的救治水平,并重视糖尿病和糖尿病足的宣教,提高患者配合治疗的依从性,以做到早发现、及时诊治,降低糖尿病足的严重程度和坏疽的发生风险。Objective Based on the results of previous studies that diabetic foot is the most common type of chronic wound in Hainan,the study aims to clarify the severity of diabetic foot residents and the risk factors of diabetic foot gangrene in Hainan Island,and to provide a scientific basis for reducing the incidence of amputation in diabetic foot patients.Methods A total of 457 diabetic foot patients from 19 hospitals in 11 cities and counties in Hainan Province were investigated from July 2022 to June 2023 using a survey design.The data collected included demographic characteristics,diabetes,and diabetic foot information.Counting data were described by frequency and percentage,and chi-square test was used for the comparison of differences between groups.A binary Logistic regression multi-factor analysis was used,and an incremental model was set up in the regression to test the impact of potential confounding factors on the results.Results The incidence of gangrene in diabetic foot patients in Hainan is 56.01%(95%CI:51.21%-61.49%),which is higher than that in other areas.Univariate analysis showed that age,lifestyle habits,medication,comorbidities,family history,and wound infection are associated with the risk of diabetic foot gangrene.Multivariate logistic regression analysis further confirmed that the independent risk factors for diabetic foot gangrene are not receiving diabetes medication,having complications/complications of diabetes,and not checking both feet daily.No significant interaction between gender and the above factors was found in the subgroup analysis.Conclusions The incidence of gangrene in diabetic foot patients in Hainan is higher than that in other areas,and the risk factors are related to the lack of standardized,timely treatment,and patients′lack of knowledge about diabetes and diabetic foot.It is suggested to speed up the construction of wound treatment centers in primary hospitals,improve the treatment level of diabetic foot,pay attention to the education of diabetes and diabetic foot,and impr

关 键 词：海南地区 糖尿病足 坏疽 风险因素 

分 类 号：R587[医药卫生—内分泌]