糖尿病手部坏疽的综合治疗11例报告

A study of systemic treatment of diabetic hand gangrene: 11 cases report

目的评估糖尿病手部坏疽综合治疗的临床效果。方法共收治糖尿病手部坏疽患者11例,自发现病变至诊治时间平均为6.2周,术前MHQ评分为61.3±7.5（55-71）分。均接受综合治疗,包括血糖控制、抗炎、清创截肢和术后处理等。结果本组11例随访12-18个月,平均13.2个月。患肢创面均完全愈合,除病变手指外,余指活动正常。术后MHQ评分为84.2±8.9（81-91）分。患侧握力为健侧的69%-83%。结论糖尿病手部坏疽的治疗需采用综合手段,在控制血糖及排除手术禁忌证后,应尽早行截指或者清创手术。

Objective To review clinical outcomes of diabetic hand gangrene by systemic treatment. MethodsSystemic treatment, including glycemic control, anti-infection, debridement and rehabilitation, was performed in 11 cases with diabetic hand gangrene. The time from the detection of the diabetic hand to gangrene was 6.2 weeks. The preoperative MHQ score was（ 61.3 ± 7.5） points（ range： 55- 71 points）. Results The mean follow-up was 13.2 months（ range： 12- 18 months）. The wounds healed completely in all cases and the rest fingers were not affected. The postoperative MHQ score was（ 84.2 ± 8.9） points（ range： 81- 91 points）. The grip force was 69%- 83% of the contralateral side postoperatively. Conclusions Systemic treatment should be conducted for the diabetic hand gangrene. After glycemic control and contraindication excluding, early debridement or amputation followed by the rehabilitation should be applied soon to reach satisfactory results.