糖尿病患者高危足筛查及分级、干预规范流程的构建

Construction of the standardized process of at-risk foot screening, stratification and intervention fordiabetic patients

目的构建我国糖尿病患者高危足筛查、分级及干预规范流程。方法查阅国内外文献，根据国际糖尿病足工作组的《糖尿病足国际临床指南》，由北京大学第一医院糖尿病足病中心多学科团队医师撰写流程初稿，并形成专家咨询问卷，对全国10个省市内分泌、整形修复外科、血管介入科的28名专家进行2轮专家咨询，最终确立高危足筛查及分级、干预规范流程。结果两轮专家咨询问卷回复率分别为93．3％、100％。专家的权威系数为0．91±0．02，第2轮专家咨询各条目的变异系数为0．05—0．20。通过德尔菲专家咨询，得出高危足筛查及多学科管理规范流程共包括4个一级指标，43个二级指标。结论本研究构建了糖尿病患者高危足筛查、分级及干预规范流程，为高危足综合管理提供框架。

Objective To construct the standardized process of at-risk foot screening, stratification and intervention. Methods Based on literature review, especially on the International Guideline of Diabetic Foot published by International Working Group of the Diabetic Foot, doctors from diabetic foot multidisciplinary group of a third-grade class-A hospital developed the first draft. Then experts＇ opinion questionnaire was developed based on the draft. Twenty eight experts from 10 provinces with endocrinology, plastic and repair surgery and endovascular treatment background were recruited, and two rounds of expert consultation were implemented. And finally the standardized process of diagnosis and treatment of diabetic foot with muhidisciplinary approach had been constructed. Result Through 2 rounds of expert consultation, the response rates were 93.3% and 100%, respectively. The authority coefficients was 0.91 ＋ 0.02. The coefficients of variation of each item ranged from 0.05-0.20. The final standardized process consisted of 4 first-level indicators and 43 second-level indicators. Conclusion We construct a standardized procedure for at-risk foot screening, stratification and intervention, which provides a frame for the comprehensive management of at-risk foot.