CAJ | 학술논문

目的：探讨个性化处理治疗糖尿病足创面的效果。方法回顾性研究1997年10月至2014年12月北京积水潭医院烧伤科及内分泌科收治的糖尿病足溃疡患者216例，在遵循控制血糖及感染的基础上，根据患者创面具体情况进行个性化处理。结果216例患者中，1例因多器官功能衰竭死亡；2例行小腿截肢术（其中1例因骨折术后感染、骨坏死截肢）；感染足趾截趾、剔骨皮瓣修复45例；清创＋负压吸引治疗14例（其中，创面直接缝合3例，负压吸引后创面植皮愈合11例）；清创＋换药＋植皮修复97例；皮瓣移植修复13例；清创＋换药治疗44例。结论个性化处理是糖尿病足创面较为理想的治疗方案。
목적：탐토개성화처리치료당뇨병족창면적효과。방법회고성연구1997년10월지2014년12월북경적수담의원소상과급내분비과수치적당뇨병족궤양환자216례，재준순공제혈당급감염적기출상，근거환자창면구체정황진행개성화처리。결과216례환자중，1례인다기관공능쇠갈사망；2례행소퇴절지술（기중1례인골절술후감염、골배사절지）；감염족지절지、척골피판수복45례；청창＋부압흡인치료14례（기중，창면직접봉합3례，부압흡인후창면식피유합11례）；청창＋환약＋식피수복97례；피판이식수복13례；청창＋환약치료44례。결론개성화처리시당뇨병족창면교위이상적치료방안。
Objective To explore the suitable wound treatment of diabetic foot for individual patient.Methods Two hundred and sixteen patients,with diabetic foot wounds,admitted in Beijing Jishuitan Hospital from Oct 1 997 to Dec 201 4,were performed personalized treatment according to given situation,except for following the principle of controlling blood sugar and infection.Results Of all the patients,1 case died of multiple organ failure,2 wounds were recovered through lower limb amputation (including 1 case of bony infection and necrosis postoperative),45 wounds were repaired with filleted flaps after the infective toes amputation.Fourteen cases were treated with debridement and vacuum sealing drainage(3 wounds were sutured directly,1 1 cases were healed with skin graft),97 cases were repaired through debridement,dressing change and sequential skin graft,1 3 wounds were reconstructed by flap transplantation,44 cases were healed by dressing change after wound debridement.Conclusion Diabetic foot was one of the most serious complications of diabetes mellitus,the ideal management should differ from patient to patient and wound to wound,the individualized treatment had to be tailor-made for the given situation.