老年人糖尿病足80例临床分析

Clinical analysis of 80 cases with diabetic foot in the elderly

目的 探讨糖尿病足的起病诱因、临床特点、治疗及预后.方法 对80例糖尿病足患者临床资料进行回顾性分析.结果 53例患者为细菌感染;存在下肢动脉严重狭窄、闭塞（狭窄率70%以上）30例,髂动脉以下完全闭塞5例,腘动脉以下完全闭塞4例;糖尿病性周围神经病变65例;有明确诱因者72例（90.0%）.痊愈40例,截肢20例,未愈出院12例,病情恶化死亡8例.结论 糖尿病足发生多数有诱因,预后与下肢动脉闭塞程度呈明显相关性,与感染情况及其他基础疾病严重程度呈相关性.应积极予控制血糖、抗感染、改善下肢血供、营养神经、局部处理、支持治疗等综合治疗.

Objective To explore the onset incentives, clinical features, treatment and prognosis of diabetic foot. Methods The clinical data of 80 patients with diabetic foot from January 2000 to October 2009 were analyzed retrospectively. Results The 53 cases had bacterial infection.Thirty cases had severe lower limb arterial stenosis or occlusion （stenosis rate ＞70%）. And iliac arteries of 5 cases and popliteal arteries of 4 cases were completely occluded. Sixty-five cases had diabetic peripheral neuropathy. Seventy two cases had clear incentive. Forty 40 cases recovered, 20 cases were amputated, 12 cases were discharged without cure, and 8 cases died. Conclusions Most of the occurrences of diabetic foot have incentives. Prognosis and degree of lower limb arterial occlusion are significantly correlated. Infection and the severity of other underlying diseases are associated with the prognosis. The diabetic patients should be treated comprehensively including controlling blood sugar, anti-infection, improving lower limb blood supply, nurturing nerve and local treatment.