中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2013年
2期
116-119
,共4页
许蕾%钱鸿洁%张杉杉%顾雪明%蔡慧丽%顾俊义%施建元%汤正义%宁光
許蕾%錢鴻潔%張杉杉%顧雪明%蔡慧麗%顧俊義%施建元%湯正義%寧光
허뢰%전홍길%장삼삼%고설명%채혜려%고준의%시건원%탕정의%저광
糖尿病足溃疡%糖尿病足感染%截肢%死亡率
糖尿病足潰瘍%糖尿病足感染%截肢%死亡率
당뇨병족궤양%당뇨병족감염%절지%사망솔
Diabetic foot ulcer%Diabetic foot infection%Amputation%Mortality
目的 分析糖尿病足溃疡感染的临床特点,探讨感染严重程度对患者预后的影响.方法 收集506例住院糖尿病足溃疡患者的资料,比较不同感染程度的患者的临床特点,观察患者溃疡治愈率、截肢率及死亡率,分析相关影响因素.结果 糖尿病足溃疡患者入院时的总体感染率为95.8％；随访1年内总体愈合率为80.6％,大小截肢率为23.3％,死亡率为8.1％.随着感染严重程度的增加,溃疡深度逐渐加重,患者血糖、血脂控制变差,蛋白水平降低,尿蛋白排出增加,截肢率、死亡率不断升高.截肢的相关危险因素为感染严重程度、糖尿病血管并发症及年龄(P＜0.05)；死亡的相关危险因素为Wagner级别、年龄、白细胞计数、白蛋白水平(P＜0.05).结论 足溃疡的感染程度与溃疡严重程度呈正相关,并严重影响患者全身状态及预后,提示需要及时控制.
目的 分析糖尿病足潰瘍感染的臨床特點,探討感染嚴重程度對患者預後的影響.方法 收集506例住院糖尿病足潰瘍患者的資料,比較不同感染程度的患者的臨床特點,觀察患者潰瘍治愈率、截肢率及死亡率,分析相關影響因素.結果 糖尿病足潰瘍患者入院時的總體感染率為95.8％；隨訪1年內總體愈閤率為80.6％,大小截肢率為23.3％,死亡率為8.1％.隨著感染嚴重程度的增加,潰瘍深度逐漸加重,患者血糖、血脂控製變差,蛋白水平降低,尿蛋白排齣增加,截肢率、死亡率不斷升高.截肢的相關危險因素為感染嚴重程度、糖尿病血管併髮癥及年齡(P＜0.05)；死亡的相關危險因素為Wagner級彆、年齡、白細胞計數、白蛋白水平(P＜0.05).結論 足潰瘍的感染程度與潰瘍嚴重程度呈正相關,併嚴重影響患者全身狀態及預後,提示需要及時控製.
목적 분석당뇨병족궤양감염적림상특점,탐토감염엄중정도대환자예후적영향.방법 수집506례주원당뇨병족궤양환자적자료,비교불동감염정도적환자적림상특점,관찰환자궤양치유솔、절지솔급사망솔,분석상관영향인소.결과 당뇨병족궤양환자입원시적총체감염솔위95.8％；수방1년내총체유합솔위80.6％,대소절지솔위23.3％,사망솔위8.1％.수착감염엄중정도적증가,궤양심도축점가중,환자혈당、혈지공제변차,단백수평강저,뇨단백배출증가,절지솔、사망솔불단승고.절지적상관위험인소위감염엄중정도、당뇨병혈관병발증급년령(P＜0.05)；사망적상관위험인소위Wagner급별、년령、백세포계수、백단백수평(P＜0.05).결론 족궤양적감염정도여궤양엄중정도정정상관,병엄중영향환자전신상태급예후,제시수요급시공제.
Objective Clinical characteristics of the infection in diabetic foot ulcers (DFU) were analyzed in regard to the severity of infection and the related prognosis.Methods The data from 506 hospitalized patients with DFU were collected,the rates of healed ulcer,amputation,and mortality were followed for 1 year.These patients were divided into different groups according to the grades of ulcer and severity of infection.Statistics was made to find their clinical characteristics and association to outcomes.Results The rate of infection in patients with DFU was 95.8％.Within one year,80.6％ of patients had ulcers cured,23.3％ of them underwent amputation of toes or legs,and 8.1％ of them died.Elevated Wagner grade,severe infection,poorly controlled hyperglycemia and lipidemia,decreased serum proteins,and marked proteinuria led to worsened DFU and increased risk of amputation and death.The degree of ulcers,diabetic vascular complication,and aging were the main risk factors of amputation; in addition,abnormal white blood cell counts and lowered serum albumin were risk factors of fatality (P ＜ 0.05).Conclusion Diabetic foot infection is positively correlated with the grading of Wagner classification,and seriously affects the general condition and prognosis of patients,suggesting that more attention should be paid to the infection control.
