糖尿病足严重程度分级指导使用经趾(跖)骨截肢术

Diabetic Foot Severity Grade Guides the Use of Toe(Metatarsal) Amputation and Suturing

目的 探讨糖尿病足严重程度分级对于经趾（跖）骨截肢并缝合术治疗糖尿病性足溃疡的指导作用。方法 对于我科2011年1月~2016年5月符合入组标准的患者分别进行回顾性研究、可行性研究。结果2011年1月~2015年1月,50例患者符合纳入标准,术后创面愈合率78.00%、一期愈合率64.00%、创面不良进展发生率16.00%。2015年2月~2016年5月,使用糖尿病足严重程度分级指导手术病例选择,31例患者符合纳入标准,术后创面愈合率96.77%、一期愈合率80.65%,创面不良进展发生率3.23%。结论 糖尿病足严重程度分级指导临床医生使用经趾（跖）骨截肢并缝合术治疗糖尿病足趾端慢性溃疡可以获得较高的创面整体愈合率、一期愈合率以及较低的创面不良进展发生率。

Objective To discuss the practicability of diabetic foot severity grade for guiding the use of toe （metatarsal） amputation and suturing. Methods Patients who met the inclusion criteria were collected for the retrospective study and feasibility research from January 2011 to May 2016. Results From January 12011 to January 2015, 50 patients met the the inclusion criteria. After operation, 78.00% patients got wound healing, 64.00% patients were primary healing, 16.00% patients had poor progress. From February 2015 to May 2016, 31 patients met the the inclusion criteria, used diabetic foot severity grade to guide the cases choice, after operation, 96.77% patients got wound healing, 80.65% patients were primary healing, 3.23% patients had poor progress. Conclusion Diabetic foot patients with chronic toe ulcer can have higher rate of overall wound healing and primary healing, and lower occurrence of poor progress when doctor used diabetic foot severity grade to guide the application of toe （metatarsal） amputation and suturing.