中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2015年
5期
355-358
,共4页
王敏%杨彩哲%关小宏%吴石白
王敏%楊綵哲%關小宏%吳石白
왕민%양채철%관소굉%오석백
糖尿病足%假单胞菌,铜绿%伤口愈合%影响因素
糖尿病足%假單胞菌,銅綠%傷口愈閤%影響因素
당뇨병족%가단포균,동록%상구유합%영향인소
Diabetic foot%Pseudomonas aeruginosa%Wound healing%Influencing factor
目的 探讨影响全耐药铜绿假单胞菌感染的重度糖尿病足坏疽(Wagner 4级以上)愈合的相关因素,从而指导临床治疗.方法 选择2009年1月至2014年7月住院的Wagner 4级以上的糖尿病足坏疽患者,患足创面分泌物培养结果为全耐药铜绿假单胞菌,共计49例,根据患者创面愈合时间是否大于3个月,分为愈合组(26例)及未愈合组(23例),比较两组一般资料、临床指标及治疗的差异,并进行多因素非条件Logistic回归分析.结果 愈合组患足足背动脉血流量高于未愈合组[(43.59±2.71) ml/min比(23.14±5.39 ml/min)],尿微量白蛋白低于未愈合组[(67.01±3.32)mg/L比(234.03±6.71) mg/L],负压吸引率高于未愈合组[(76.9％(20/26)比47.8％(11/23)],差异均有统计学意义(P＜ 0.05或＜0.01).多因素非条件Logistic回归分析显示影响愈合的相关因素为患足足背动脉血流量(回归系数=-5.551,P=0.001)、尿微量白蛋白(回归系数=0.127,P=0.007)、是否负压吸引(回归系数=-2.244,P=0.042).结论 全耐药铜绿假单胞菌感染的重度糖尿病足坏疽患者影响愈合的相关因素为患足足背动脉血流量、尿微量白蛋白及负压吸引治疗.
目的 探討影響全耐藥銅綠假單胞菌感染的重度糖尿病足壞疽(Wagner 4級以上)愈閤的相關因素,從而指導臨床治療.方法 選擇2009年1月至2014年7月住院的Wagner 4級以上的糖尿病足壞疽患者,患足創麵分泌物培養結果為全耐藥銅綠假單胞菌,共計49例,根據患者創麵愈閤時間是否大于3箇月,分為愈閤組(26例)及未愈閤組(23例),比較兩組一般資料、臨床指標及治療的差異,併進行多因素非條件Logistic迴歸分析.結果 愈閤組患足足揹動脈血流量高于未愈閤組[(43.59±2.71) ml/min比(23.14±5.39 ml/min)],尿微量白蛋白低于未愈閤組[(67.01±3.32)mg/L比(234.03±6.71) mg/L],負壓吸引率高于未愈閤組[(76.9％(20/26)比47.8％(11/23)],差異均有統計學意義(P＜ 0.05或＜0.01).多因素非條件Logistic迴歸分析顯示影響愈閤的相關因素為患足足揹動脈血流量(迴歸繫數=-5.551,P=0.001)、尿微量白蛋白(迴歸繫數=0.127,P=0.007)、是否負壓吸引(迴歸繫數=-2.244,P=0.042).結論 全耐藥銅綠假單胞菌感染的重度糖尿病足壞疽患者影響愈閤的相關因素為患足足揹動脈血流量、尿微量白蛋白及負壓吸引治療.
목적 탐토영향전내약동록가단포균감염적중도당뇨병족배저(Wagner 4급이상)유합적상관인소,종이지도림상치료.방법 선택2009년1월지2014년7월주원적Wagner 4급이상적당뇨병족배저환자,환족창면분비물배양결과위전내약동록가단포균,공계49례,근거환자창면유합시간시부대우3개월,분위유합조(26례)급미유합조(23례),비교량조일반자료、림상지표급치료적차이,병진행다인소비조건Logistic회귀분석.결과 유합조환족족배동맥혈류량고우미유합조[(43.59±2.71) ml/min비(23.14±5.39 ml/min)],뇨미량백단백저우미유합조[(67.01±3.32)mg/L비(234.03±6.71) mg/L],부압흡인솔고우미유합조[(76.9％(20/26)비47.8％(11/23)],차이균유통계학의의(P＜ 0.05혹＜0.01).다인소비조건Logistic회귀분석현시영향유합적상관인소위환족족배동맥혈류량(회귀계수=-5.551,P=0.001)、뇨미량백단백(회귀계수=0.127,P=0.007)、시부부압흡인(회귀계수=-2.244,P=0.042).결론 전내약동록가단포균감염적중도당뇨병족배저환자영향유합적상관인소위환족족배동맥혈류량、뇨미량백단백급부압흡인치료.
Objective To investigate the factors related to healing of severe diabetic foot gangrene (Wagner 4 class above) infected with pan-resistant Pseudomonas aeruginosa,and to guide clinical treatment.Methods Forty-nine hospitalized patients with diabetic foot gangrene (Wagner 4 class above) from January 2009 to July 2014 were enrolled.The affected foot wound secretion culture was pan-resistant Pseudomonas aeruginosa.According to the wound healing time,they were divided into wound healing group (26 cases,healing time ≤ 3 months) and wound un-healing group (23 cases,healing time ＞ 3 months).The general information,clinical indicators and treatment between two groups were compared,and the factors related to healing was analyzed by multi-factor unconditioned Logistic regression analysis.Results Compared with those in wound un-healing group,the blood flow volume of dorsal artery of affected foot and negative pressure attraction rate in wound healing group were higher:(43.59 ± 2.71) ml/min vs.(23.14 ± 5.39) ml/min,76.9％ (20/26) vs 47.8％(11/23),and the urinary micro-albumin was lower:(67.01 ± 3.32) mg/L vs.(234.03 ± 6.71) mg/L.There were significant differences (P ＜ 0.05 or ＜ 0.01).Multi-factor unconditioned Logistic regression analysis showed that the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa were the blood flow volume of dorsal artery of affected foot (regression coefficient was-5.551,P =0.001),urinary micro-albumin (regression coefficient was 0.127,P =0.007) and negative pressure attraction (regression coefficient was-2.244,P =0.042).Conclusion The blood flow volume of dorsal artery of affected foot,urinary micro-albumin,negative pressure attraction are the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa.
