2235例麻风垂足的分析

Analysis of foot-drop in 2235 cases of leprosy

目的 : 了解麻风垂足的患病情况 ,为制定预防措施提供科学依据。方法 : 选择江苏 11个县市存活的麻风治愈者及现症患者为调查对象 ,资料输入计算机统计分析。结果 : 麻风垂足的患病率为 15 .7% ,单足 (13.6 2 % )高于双足 (2 .0 7% ) ,男性 (16 .39% )高于女性 (13.84 % ) ,现症及复发病人(31.2 8% )高于治愈者 (15 .0 7% ) ,BT、BB型麻风占 2 3.5 6 %及 2 0 .96 %。麻风病期在 5年以内发生垂足的少菌型麻风 (72 .4 1% )高于多菌型 (5 0 .4 7% ) ;发生过麻风反应的患者垂足占 33.75 %。垂足有足底溃疡 (2 1.2 1% )、足骨破坏 (19.17% )及足畸形 (2 7.4 3% )多于无垂足的溃疡 (15 % )、骨破坏 (15 .0 9% )及足畸形 (2 0 .19% )。 989只垂足可通过手术矫治 ,要求治疗者只占 30 %。结论 : 麻风垂足以男性、现症及复发病人多见且以单足为主 ,垂足发生的足底溃疡及足畸形明显增多 ,三分之二的垂足失去了手术矫治的机会 ,70 %的患者对垂足的治疗没有信心。麻风垂足的发生与麻风诊断和治疗的延迟。

Objective:To determine the prevalence of foot-drop in the leprosy patients in order to provide scientific evidence for a prevention program. Method:All the leprosy patients, both cured and active, in 11 counties of Jiangsu Province were investigated. Results: Among the cases investigated, the prevalence of foot-drop was 15.7%. The prevalence of foot-drop in one leg (13.62%) was higher than bilateral feet (2.07%). There were more males ( 16.39% ) with foot-drop than females (13.84%). The prevalence of foot-drop in active or relapsed cases ( 31.28% ) was higher than the cured (15.07%). And the prevalence of foot-drop in BT and BB leprosy cases was 23.56% and 20.96% respectively. In the group of patients with the disease less than 5 years, the prevalence of foot-drop was higher in PB (72.41%) than in MB (50.47%). In the patients who had lepra reaction the prevalence of foot-drop was 33.75%. The prevalence of plantar ulcers (21.21%), bone damage (19.17%) and foot deformity ( 27.43% ) was higher in the patients with foot-drop than those without foot-drop,whose plantar ulcers, bone damage and foot disability being 15%, 15.09% and 20.19%, respectively. Among 989 cases of foot-drop, only 30% demanded to be reconstructed with operations. Conclusion : Foot-drop is more common among active and relapsed cases and more prevalent in one leg. The plantar ulcers and foot disabilities more frequently occur in patients with foot-drop. Two thirds of foot-drop are not suitable for reconstructive surgeries and 70% of the patients with foot-drop haven't much faith in the treatment. Occurrence of foot-drop is associated with delay of diagnosis and treatment, lepra reaction and the type of leprosy.