不同部位糖尿病足溃疡愈合情况分析

Wound healing of diabetic foot ulcers occurring at different sites

目的了解不同部位糖尿病足溃疡愈合情况。方法采用前瞻性研究方法,对142例Wagner分级2~4级的糖尿病足溃疡患者采取多学科协作的综合治疗方法,收集入院首次临床检查资料,留取入院每次清创后足溃疡照片,比较治疗30d内不同部位的足溃疡创面缩小率。结果发生在足背、足踝、足弓、足趾、足前掌及足跟的Wagner分级为2级的溃疡创面缩小率比较,差异有统计学意义(P<0.01),发生在足趾的糖尿病足溃疡创面缩小率最小,足踝部及足背部溃疡创面缩小率较大。Wagner分级为2、3级的非受压组溃疡创面缩小率显著大于受压组(均P<0.01)。结论不同部位糖尿病足溃疡愈合存在差异,治疗糖尿病足过程中采取适当的减压措施有利于糖尿病足溃疡的愈合。

Objective To study wound healing status of diabetic foot ulcers occurring at different sites. Methods A prospectiw： study enrolled 142 hospitalized patients with Wagner grade 2-4 diabetic foot ulcer, who then received multidisciplinary treatment. Lab data on the admission day of the 142 patients were collected and the pictures of the foot ulcers were taken after each debridement and dressing change. The healing situation of the wounds within 1 month was observed. Results At one month, wound shrinking rates of Wagner grade 2 ulcers occurring at the dorsal, ankle, arch, toes, palm, or heel of the foot, had significant differences （P〈0.01）, with shrinking rate of ulcers at the toes being the smallest, and at the ankle and dorsal part being the highesl. Wound shrinking rates of Wagner grade 2--3 ulcers under pressure were significantly lower than those under no pressure （P〈0. 01 for all）. Conclusion The sites of foot ulcer affect wound healing, which can be boosted by proper decompression measures.