糖尿病合并创伤性气性坏疽的临床特点及治疗对策

A study on the clinical characteristics and therapeutic and strategy of traumatic gas gangrene in diabetics

目的分析糖尿病患者创伤后气性坏疽的临床特点，并探讨其治疗策略。方法对9例糖尿病合并创伤后气性坏疽及同期收治的11例非糖尿病气性坏疽患者进行回顾性对比分析。结果与非糖尿病合并气性坏疽患者比较，糖尿病合并气性坏疽患者感染细菌的种类更多、更复杂，病情更重，平均住院时间更长[两组平均住院时间分别为（40．9±7．1）天和（54．4±10．2）天，P〈0．05]。结论糖尿病是气性坏疽的易患因素之一。早期诊断及处理，加强换药，足量全程应用抗生素控制感染，严格胰岛素控制血糖，是治疗成功的关键。

Objective To study the clinical characteristics of traumatic gas gangrene in diabetics and search for a therapeutic strategy. Methods Medical records of 9 cases with traumatic gas gangrene in diabetics and 11 cases with nondiabetic traumatic gas gangrene were reviewed critically and retrospectively. Results Compared with nondiabetic traumatic gas gangrene, conditions of the patients with traumatic gas gangrene in diabetics were more serious, the kinds of pathogens were more complicated, and the mean hospitalization time was longer [ the mean hospitalization time of each group is （40.9 ± 7.1 ） days and （54.4 ± 10.2） days respectively, P 〈 0.05 ]. Conclusions Diabetes mellitus was one of the important predisPosing factors in gas gangrene. Early diagnose and disposal, strengthened change of dressing with intravenous antibiotics and insulin are crucial for the improvement of the outcome of the disease.