中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2013年
11期
652-655
,共4页
刘倩%李代清%柳雷%孙茜%杨蔚%张达%褚月颉%王鹏华
劉倩%李代清%柳雷%孫茜%楊蔚%張達%褚月頡%王鵬華
류천%리대청%류뢰%손천%양위%장체%저월힐%왕붕화
糖尿病足%抑郁%溃疡%截肢(趾)
糖尿病足%抑鬱%潰瘍%截肢(趾)
당뇨병족%억욱%궤양%절지(지)
Diabetic foot%Depression%Ulcer%Amputation
目的 通过对糖尿病足溃疡住院患者进行心理评估,探讨抑郁情绪对患者预后的影响.方法 对2010年6月至2011年5月因糖尿病足病住院的168例Wagner 3级足溃疡患者应用抑郁自评量表进行评估,按照抑郁程度分为不伴抑郁组和伴抑郁组,采用logistic回归分析抑郁情绪对糖尿病足患者足溃疡愈合以及对足溃疡愈合的患者行截肢手术的影响.结果 Wagner 3级患者中伴抑郁症者95例(56.5％),不伴抑郁症者73例(43.5％).卡方检验证实伴抑郁者溃疡不愈合率较不伴抑郁者显著增加(分别为18.9％和6.8％,OR=2.779,95％ CI:1.120 ～9.023),logistic回归分析发现,在依次调整了与足溃疡预后密切相关的感染程度与动脉病变程度以及年龄、糖化血红蛋白、合并症Charlson评分等因素后,抑郁仍是患者溃疡不愈合的危险因素(OR=3.569,95％CI:1.220～10.442).进一步对溃疡愈合组患者进行logistic回归发现,在依次调整上述因素后,抑郁情绪的存在也是溃疡愈合组患者截肢的危险因素(OR=2.793,95％ CI:1.361 ～ 5.732).结论 糖尿病足溃疡患者普遍存在抑郁情绪并对患者预后产生不利影响.对其进行筛查并给予必要的心理治疗,可降低住院糖尿病足溃疡患者的手术风险.
目的 通過對糖尿病足潰瘍住院患者進行心理評估,探討抑鬱情緒對患者預後的影響.方法 對2010年6月至2011年5月因糖尿病足病住院的168例Wagner 3級足潰瘍患者應用抑鬱自評量錶進行評估,按照抑鬱程度分為不伴抑鬱組和伴抑鬱組,採用logistic迴歸分析抑鬱情緒對糖尿病足患者足潰瘍愈閤以及對足潰瘍愈閤的患者行截肢手術的影響.結果 Wagner 3級患者中伴抑鬱癥者95例(56.5％),不伴抑鬱癥者73例(43.5％).卡方檢驗證實伴抑鬱者潰瘍不愈閤率較不伴抑鬱者顯著增加(分彆為18.9％和6.8％,OR=2.779,95％ CI:1.120 ～9.023),logistic迴歸分析髮現,在依次調整瞭與足潰瘍預後密切相關的感染程度與動脈病變程度以及年齡、糖化血紅蛋白、閤併癥Charlson評分等因素後,抑鬱仍是患者潰瘍不愈閤的危險因素(OR=3.569,95％CI:1.220～10.442).進一步對潰瘍愈閤組患者進行logistic迴歸髮現,在依次調整上述因素後,抑鬱情緒的存在也是潰瘍愈閤組患者截肢的危險因素(OR=2.793,95％ CI:1.361 ～ 5.732).結論 糖尿病足潰瘍患者普遍存在抑鬱情緒併對患者預後產生不利影響.對其進行篩查併給予必要的心理治療,可降低住院糖尿病足潰瘍患者的手術風險.
목적 통과대당뇨병족궤양주원환자진행심리평고,탐토억욱정서대환자예후적영향.방법 대2010년6월지2011년5월인당뇨병족병주원적168례Wagner 3급족궤양환자응용억욱자평량표진행평고,안조억욱정도분위불반억욱조화반억욱조,채용logistic회귀분석억욱정서대당뇨병족환자족궤양유합이급대족궤양유합적환자행절지수술적영향.결과 Wagner 3급환자중반억욱증자95례(56.5％),불반억욱증자73례(43.5％).잡방검험증실반억욱자궤양불유합솔교불반억욱자현저증가(분별위18.9％화6.8％,OR=2.779,95％ CI:1.120 ～9.023),logistic회귀분석발현,재의차조정료여족궤양예후밀절상관적감염정도여동맥병변정도이급년령、당화혈홍단백、합병증Charlson평분등인소후,억욱잉시환자궤양불유합적위험인소(OR=3.569,95％CI:1.220～10.442).진일보대궤양유합조환자진행logistic회귀발현,재의차조정상술인소후,억욱정서적존재야시궤양유합조환자절지적위험인소(OR=2.793,95％ CI:1.361 ～ 5.732).결론 당뇨병족궤양환자보편존재억욱정서병대환자예후산생불리영향.대기진행사사병급여필요적심리치료,가강저주원당뇨병족궤양환자적수술풍험.
Objective To evaluate the impact of depression on prognosis of Wagner grade 3 diabetic foot ulcer patients by a psychological assessment.Methods One hundred and sixty-eight patients suffered from Wagner grade 3 diabetic foot ulcers hospitalized in the Tianjin Metabolic Diseases Hospital from June 2010 to May 2011 were included in the study.Their psychological disorders were evaluated by a self-rating depression scale (SDS) to identify depression.Patients complicated with depression or not were divided into two groups accordingly.Unhealing rate and amputation risk of the patients in the two groups were compared using Chi-square test and logistic regression,respectively.Results Ninety-five out of 168 patients (56.5％) were identified as depression and the others (73 out of 168,43.5％) were not.The unhealing rate of the patients complicated with depression was significantly higher than that of the patients without depression analyzed by Chi-square test (18.9％ and 6.8％ respectively,OR =2.779,95％ CI:1.120-9.023).Logistic regression analysis indicated that depression was a risk factor of unhealed ulcers (OR =3.569,95％ CI:1.220-10.442) after the factors related to prognosis of diabetic foot ulcer were adjusted step-by-step,including infection,arterial disease,age,glycosylated hemoglobin A1e and Charlson grading of complications.Healed patients were further analyzed by logistic regression analysis.Healing after amputation rate is higher among the patients complicated with depression than that of the patients without depression after the adjustment mentioned above (OR =2.793,95％ CI:1.361-5.732).Conclusion Depression is common among patients with Wagner grade 3 diabetic foot ulcers and has adverse effects on the prognosis of the patients.It implies that identification of depressed should be a routine process for diabetic foot ulcer patients to improve wound healing and reduce amputation rate.
