CAJ | 학술논문

目的：通过近5年对糖尿病足病例的回顾性研究，寻找发现治疗糖尿病足中的问题并分析其原因，找出怎样规范化治疗糖尿病足的方法，为同道提供参考。方法：对2003年9月～2012年9月在本院治疗的66例糖尿病足患者病案资料回顾性研究，对其中50例进行随访研究，随访时间3个月～6年。对于保守治疗无效进行清创、植皮、截肢（截趾）处理及术后肢体功能、病灶复发、坏死面积继续扩大等问题逐步找出问题和缺陷，逐项分析原因，并根据临床经验和教训进行总结，提出规范化治疗糖尿病足的具体方案。结果：经过50例截肢（截趾）患者术后没有再次发生坏疽的44例，成功率为88％，术后继发坏疽二次截肢（截趾）2例，失败率为4％，创面感染17例，感染率为34％，其原因多数为远端微循环通道已经丧失。结论：及时发现和治理糖尿病足是问题的关键，在治疗的同时参考多学科给予的治疗意见对糖尿病足治疗及预防将会起到重要的作用。对糖尿病足远端微循环做出准确的评估会降低复发和2次手术的频率。
목적：통과근5년대당뇨병족병례적회고성연구，심조발현치료당뇨병족중적문제병분석기원인，조출즘양규범화치료당뇨병족적방법，위동도제공삼고。방법：대2003년9월～2012년9월재본원치료적66례당뇨병족환자병안자료회고성연구，대기중50례진행수방연구，수방시간3개월～6년。대우보수치료무효진행청창、식피、절지（절지）처리급술후지체공능、병조복발、배사면적계속확대등문제축보조출문제화결함，축항분석원인，병근거림상경험화교훈진행총결，제출규범화치료당뇨병족적구체방안。결과：경과50례절지（절지）환자술후몰유재차발생배저적44례，성공솔위88％，술후계발배저이차절지（절지）2례，실패솔위4％，창면감염17례，감염솔위34％，기원인다수위원단미순배통도이경상실。결론：급시발현화치리당뇨병족시문제적관건，재치료적동시삼고다학과급여적치료의견대당뇨병족치료급예방장회기도중요적작용。대당뇨병족원단미순배주출준학적평고회강저복발화2차수술적빈솔。
Objective:Through a retrospective study of cases of diabetic foot nearly the past five years , to find out the problems in treatment of diabetic foot and to analyze the reasons , to find out the standard treatment of diabetic foot and to provide a reference for the fellows.Methods:To study the medical records of 66 cases of diabetic foot patients who treated in our hospital from September 2003 to September 2012, to follow-up study on 50 patients from 3 months to 6 years.For debridement, skin grafting, amputated (cut toe) pro-cessing and function of limbs , recurrences , necrotic area continues to expand gradually to identify problems and defects in patients with conservative treatment fails , then itemized analysis of the reasons , based on clinical experience and the lessons learned from the summary;and finally to proposes the standardized treatment of specific programs for the treatment of diabetic foot .Results:In 50 patients with am-putated (cut toe) surgery patients, 44 patients did not happen again gangrene , a success rate of 88%;2 patients with secondary gan-grene secondary the amputation ( cut-off toe) , the failure rate was 4%;17 cases of wound infection , the infection rate was 34%; the reason was that the majority of remote microcirculation channel has been lost .Conclusion:The key issue is the timely detection and man-agement of diabetic foot;in the same time,to reference multidisciplinary treatment given advice on diabetic foot treatment and prevention will play an important role .To make an accurate assessment of the distal diabetic foot microcirculation will reduce the frequency of recur -rence and reoperation .