综合治疗对老年糖尿病患者早期足部病变的影响

Effect of comprehensive treatment on elderly diabetes patients with early diabetic foot lesion

目的：探讨综合治疗对老年糖尿病患者早期足病病变的影响。方法使用远红外热像仪检测老年糖尿病患者双下肢皮肤温度，比较双下肢测温区的温度差，对出现温度差异的106例患者实施药物治疗干预、物理干预，健康指导等综合治疗，比较干预前后双下肢温度差、异常面积、患者不适症状及血糖。结果本组患者干预前双下肢温度差（1．91±1．21）℃，异常面积（9．90±5．52）cm2，干预后3个月双下肢温度差（0．21±0．12）℃，异常面积（1．90±0．52）cm2，差异均有统计学意义（t值分别为8．817，11．574；P＜0．01）；干预前患者糖化血红蛋白平均（7．90±1．32）％，干预后3个月平均（6．88±0．52）％，差异有统计学意义（t＝7．402，P＜0．01）。干预后3个月患者主诉双下肢不适症状均有改善。结论使用远红外热像技术能够及时发现老年糖尿病足部皮肤内部的温度异常影像改变，针对性实施药物治疗干预、物理干预、健康指导等综合治疗，可有效预防糖尿病足部并发症。

Objective To study the effect of comprehensive treatment on elderly diabetes patients with early diabetic foot lesion .Methods Infrared thermography was used to check the temperature of double lower-limb skin in elderly patients with diabetes , then the temperature difference of both sides was compared .A total of 106 patients received comprehensive treatment of drug treatment intervention , physical intervention , health guidance, whose graphic showed the temperature difference .Then, observed the values of temperature difference , positive area, discomfort and blood glucose of patients before and after the intervention .Results Significant differences were showed in terms of the values of temperature difference [（1.91 ±1.21） vs （0.21 ±0.12）℃;t=8.817,P〈0.01] positive area change situation of lower limbs [（9.90 ±5.52） vs （1.90 ±0.52）cm2;t=11.574,P〈0.01], HbA1C [（7.90 ±1.32） vs （6.88 ±0.52）%;t=7.402,P〈0.01]before and 3 months after intervention among 106 elderly diabetes patients with early diabetic foot lesion .Conclusions It was found that infrared thermography had a positive effect on finding abnormal imaging changes of the foot skin temperature in elderly patients with diabetes timely .And comprehensive treatment of drug treatment intervention , physical intervention , health guidance can effectively prevent diabetic foot complications happening .