糖尿病足截肢平面及愈合因素的分析

Analyzing factors of the amputated level and wound healing of diabetic foot

目的探讨糖尿病足截肢平面和截肢后切口愈合的影响因素。方法收集1998年1月至2009年12月出院的82例糖尿病足截肢患者临床资料,分别分析糖尿病足截肢平面与病程、外周神经障碍、血管狭窄程度、Wagner分级、创面感染情况的相关性,以及截肢后切口愈合情况与年龄、围手术期血糖控制水平、血管狭窄程度、外周神经障碍、Wagner分级、创面感染情况的相关性。结果糖尿病足截肢平面的选择与病程、外周神经障碍、血管狭窄程度有关(P<0.05);截肢后切口愈合情况与年龄、血糖控制水平及血管狭窄程度相关(P<0.05)。结论糖尿病足截肢平面的选择应通过病程、外周神经病变和血管狭窄程度量化分析;高龄、围手术期血糖控制不佳及重度血管狭窄是糖尿病足截肢后切口愈合欠佳的主要因素。

Objective To explore the factor of the level of amputatation and post-amputated incision healing of diabetic foot. Methods Clinical data of eighty two patients who were amputated for diabetic foot from January 1998 to December 2009 were collected in this study. Then correlations were analyzed between choice of amputation level or wound healing and major independent factor respectively. In order to detect the independent factors associated with major amputation level and wound healing of post-amputation, some clinical information was analyzed including disease course, angiemphraxis degree, peripheral neuropathy, advanced age, blood glucose and serious angiostenosis. Results The major amputation level was associated with disease course, angiemphraxis degree, peripheral neuropathy. Moreover, the wound healing of post-amputation was associated with advanced age, blood glucose and serious angiostenosis. Conclusions Disease course, angiemphraxis degree and peripheral neuropathy were standards to choose the level of amputation for diabetic foot（P0.05）. Moreover, advanced age, blood glucose and serious angiostenosis are major factors for mal-healing of amputated wound（P0.05）.