CAJ | 학술논문

目的评价糖尿病足专科综合治疗对糖尿病足患者住院时间以及截肢率的影响.方法回顾性分析2004年至2010年中山大学孙逸仙纪念医院内分泌科收治的361例糖尿病足患者,以2008年为切点将研究对象分为两组,2004-2007年收治的179例作为传统治疗组,2008-2010年收治的182例为综合治疗组,其中,传统治疗组的治疗包括全身代谢紊乱的控制、伤口抗感染及一般换药等,而综合治疗则包括全身状况及足部情况评估、创面的规范处理(包括溃疡清创、合理地运用敷料等)、代谢紊乱纠正、营养神经、抗血小板以及血管重建等,比较两组患者住院相关生化检查结果、住院时间及截肢情况.结果两组患者人院时在年龄、糖尿病病程、血压、体重指数、腰臀比、空腹血糖、餐后血糖、糖基化血红蛋白以及糖尿病相关并发症发病情况等方面,差异均无统计学意义(P＞0.05).传统治疗组平均住院时间为(28.73±24.86)d、综合治疗组为(23.47士17.48)d,两组比较差异有统计学意义(t=2.326,P=0.021)；两组的总截肢率分别为18.4%、8.8%(P=0.007),大范围截肢(踝平面以上)率为10.6%、4.9% (P=0.013).结论糖尿病足综合治疗可以缩短糖尿病足患者的住院时间,降低截肢率,改善患者生活质量,减轻经济负担.
목적 평개당뇨병족전과종합치료대당뇨병족환자주원시간이급절지솔적영향.방법 회고성분석2004년지2010년중산대학손일선기념의원내분비과수치적361례당뇨병족환자,이2008년위절점장연구대상분위량조,2004-2007년수치적179례작위전통치료조,2008-2010년수치적182례위종합치료조,기중,전통치료조적치료포괄전신대사문란적공제、상구항감염급일반환약등,이종합치료칙포괄전신상황급족부정황평고、창면적규범처리(포괄궤양청창、합리지운용부료등)、대사문란규정、영양신경、항혈소판이급혈관중건등,비교량조환자주원상관생화검사결과、주원시간급절지정황.결과 량조환자인원시재년령、당뇨병병정、혈압、체중지수、요둔비、공복혈당、찬후혈당、당기화혈홍단백이급당뇨병상관병발증발병정황등방면,차이균무통계학의의(P＞0.05).전통치료조평균주원시간위(28.73±24.86)d、종합치료조위(23.47사17.48)d,량조비교차이유통계학의의(t=2.326,P=0.021)；량조적총절지솔분별위18.4%、8.8%(P=0.007),대범위절지(과평면이상)솔위10.6%、4.9% (P=0.013).결론 당뇨병족종합치료가이축단당뇨병족환자적주원시간,강저절지솔,개선환자생활질량,감경경제부담.
Objective To evaluate the effect of multidlsciplinary treatment on the duration of hospitalization and amputation rate in patients with diabetic foot.Methods Retrospective analysis was made in 361 cases of diabetic foot admitted to Department of Endocrinology,Sun Yat-sen Memorial Hospital from 2004 to 2010.Patients were divided into two groups:179 cases from 2004 to 2007,were regarded as conventional therapy group; 182 cases from 2008 to 2010 served as multidisciplinary therapy group.Traditional therapy included the treatment of systemic metabolism disturbance,wound infection and resistance of general medicine,and muhidisciplinary therapy included body and foot conditions evaluation,specific wound treatment ( including ulcer debridement and reasonable application of dressings ),nerve metabolism disorders correction,nutrition and anti-platelet and vascular remodeling.The hospital-related biochemical test results,duration of hospitalization and amputation were compared between two groups.Results Age,duration of diabetes,blood pressure,body mass index,waist-hip ratio,fasting blood glucose,postprandial blood sugar,glycosylated hemoglobin Alc,low density lipoprotein,high density lipoproteins,triglyceride,cholesterol,fibrinogen and the incidence of diabetic complications showed no statistically significant differences.The difference of average length of stay between the conventional therapy group [(28.73 ±24.86) d] and the multidisciplinary therapy group [(23.47 ± 17.48) d],was statistically significant ( t =2.326,P =0.021 ).The total amputation rates in the two groups were 18.4％,8.8％ (P =0.007 ),and a wide range of amputations rates (ankle above the plane) were 10.6％,4.9％(P =0.013 ),respectively.Conclusion Diabetic foot multidisciplinary treatment can reduce patients' length of stay and amputation,improve their quality of life and reduce the financial burden.