糖尿病足骨髓炎抗生素治疗时程及预后影响因素  

Study on the duration of antibiotic therapy and prognostic factors for osteomyelitis of diabetes foot

作　　者：姚远 吴静[1] 郑新莉 张姣 郑伟 YAO Yuan;WU Jing;ZHENG Xinli;ZHANG Jiao;ZHENG Wei(Department of Endocrinology,Mingguang People's Hospital,Chuzhou 239473,Anhui,China;Cadre Ward,the 903th Hospital of the Joint Logistics Support Force,PLA,Hangzhou 310013,Zhejiang,China;Department of Ultra-sound,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]明光市人民医院内分泌科,滁州239473 [2]解放军联勤保障部队第九〇三医院干部病房,杭州310013 [3]东部战区总医院超声诊断科,南京210002

出　　处：《医学研究与战创伤救治》2025年第1期63-66,共4页Journal of Medical Research & Combat Trauma Care

摘　　要：目的探讨糖尿病足骨髓炎治疗过程中抗生素的使用时间对预后的影响。方法收集2022年6月至2024年5月明光市人民医院内分泌科因糖尿病足感染就诊的患者。将确诊糖尿病足的患者随机分成2组:短程组(抗生素治疗20 d,n=78)、长程组(抗生素治疗35 d,n=79)。比较两组中发生骨髓炎患者的临床结局,并通过Logistic回归分析影响骨髓炎愈合的风险因素。结果短程组36例患者发生糖尿病足骨髓炎,其中,24例骨髓炎完全缓解,22例糖尿病创面愈合;长程组40例发生糖尿病足骨髓炎,其中,26例骨髓炎完全缓解,24例糖尿病创面愈合。Logistic回归分析结果显示,DFI创面评分>16、红蓝光照射、下肢动脉介入或手术治疗及部分切除感染/坏死骨组织是影响糖尿病足骨髓炎临床预后的因素(P<0.05)。结论糖尿病足骨髓炎的治疗过程可适当控制抗生素的使用时间,有助于降低细菌耐药;患者的初始糖尿病创面评分与预后相关,治疗过程中,应积极开展红蓝光照射治疗、微创治疗扩张血管,改善血供,促进愈合,严格控制开展部分切除感染/坏死骨组织的手术。Objective To compare the effects of the duration of antibiotic therapy on the prognosis of osteomyelitis of diabetic foot.Methods We prospectively recruited the patients with diabetic foot infections from June 2022 to May 2024 in the Endocrinology Department of Mingguang People´s Hospital.These patients were randomly divided into two groups:one receiving short-term antibiotic therapy(20 days,n=78)and the other receiveing long-term antibiotic treatment(35 days,n=79).The clinical outcomes of these patients with osteomyelitis were compared.The risk factors affecting the osteomyelitis remission were analyzed by Logistic regression.Results In the short-term antibiotic treatment group,36 patients developed osteomyelitis of diabetes foot,with 24 patients achieving complete remission and 22 patients experiencing diabetic wound healing.In the long-term antibiotic group,40 patients developed osteomyelitis of diabetic foot with 26 patients achieving complete remission of osteomyelitis and 24 patients experiencing diabetic wound healing.Logistic regression analysis showed that diabetic foot infection(DFI)wound score>16,red and blue light therapy,lower limb artery intervention or surgical treatment,and partial amputation of infected and necrotic bones were significant factors affecting osteomyelitis remission in diabetic foot(P<0.05).Conclusion We should properly control the use time of antibiotics during the treatment of osteomyelitis of diabetic foot,which is helpful to reduce bacterial resistance.The initial DFI wound score is a prognostic indicator,and Interventions such as Red and blue light therapy,minimally invasive treatments to improve blood and oxygen supply,and cautious partial amputation of infected and necrotic bones are recommended to enhance outcomes.

关 键 词：糖尿病足骨髓炎 抗生素 风险因素 

分 类 号：R587.1[医药卫生—内分泌]