糖尿病足57例临床诊治分析

Clinical analysis of 57 cases with diabetic foot

目的探讨糖尿病足的综合防治策略。方法对57例糖尿病足患者的临床发病相关因素、诊断及治疗效果进行回顾性分析。结果糖尿病足发生坏疽的危险因素包括高龄、女性患者、HDL-C降低、LDL-C升高、收缩压升高、血糖控制差等,与非坏疽组比较有显著性意义(P<0.05)。足病溃疡面分泌物细菌培养药物敏感试验显示常用抗生素的耐药率达50%～70%。结论 Wagner足病分级Ⅰ～Ⅲ级患者疗效90%以上,Ⅳ～Ⅴ级患者疗效差,截肢(趾)率高。提示对糖尿病足的早期筛查和诊治、高危险因素的综合防治并达标,是从根本上改变糖尿病足病预后不良的有效方法。

Objective To analyze correlated pathogenic factors,clinical diagnosis and therapeutic effect of diabetic foot,to explore strategies to prevent and treat it.Methods The data of 57 in-patients with diabetic foot were analyzed retrospectively.Results Risk factors of diabetic foot gangrene include advanced age,female,decreased HDL-C,increased LDL-C,elevation of systolic pressure and poor glycaemic control.The secretion of diabetic foot ulcers were cultured,and antibiotic susceptibility tests were done.It showed that the resistance rate to the common antibiotics was 50~70 percent.Conclusion Patients with Wagner grade Ⅰ~Ⅲ diabetic foot ulcers have good therapeutic effect,and the effective is high to 90%;but patients with grade Ⅳ-Ⅴ ulcers have bad therapeutic effect and amputations.It is important to improve the prognosis of diabetic foot that the disease should be screened,diagnosed and treated early,and the high risk factors shouled be controlled comprehensively.