手术清创对湿性坏死性糖尿病足引发进行性低蛋白血症影响

Effect of Surgical Debridement on Progressive Hypoproteinaemia Induced by Moist Necrotic Diabetic Feet

目的探讨手术清创对湿性坏死性糖尿病足引发进行性低蛋白血症的影响。方法整理2010年5月—2013年5月在本院就诊的30例湿性坏死性糖尿病足患者临床资料,对其手术时机、临床表现及血浆白蛋白、血红蛋白含量等实验室检查进行回顾性分析。结果患者入院后短时间内出现进行性低白蛋白血症和贫血,清创（包括截肢术）前后到低谷,3~5 d后开始稳步上升,其中术前第2天血白蛋白和血红蛋白水平与术前第9天比较有显著差异,术后第1天血白蛋白和血红蛋白水平与术后第9天比较有显著差异（P〈0.01）。结论湿性坏死性糖尿病足患者常伴有进行性低蛋白血症,而及时手术彻底清创是防止其进一步恶化的有效治疗。

Objective To investigate the effect of surgical debridement on progressive hypoproteinaemia induced by moist necrotic diabetic feet. Methods Clinical data of 30 patients with moist necrotic diabetic feet was collected,and the selected operative time,clinical manifestations and results of laboratory examinations such as contents of plasma-albumin and haemoglobin were retrospectively analyzed. Results The progressive hypoproteinaemia and anemia appeared in patients shortly after admission,which reached all-time low before or after debridement（ including amputation of limbs）, and steadily rose in postoperative 3- 5 d. The levels of serum albumin and hemoglobin on preoperative 2 d were significantly different,compared with those on preoperative 9 d,and the levels postoperative 1 d were significantly different compared with those postoperative 9 d（ P ＆lt; 0. 01）. Conclusion Moist necrotic diabetic foot is often accompanied by progressive hypoproteinaemia,and timely and thorough surgical debridement may effectively prevent further deterioration.