糖尿病足溃疡早期影像学干预对减少截肢率的影响

Effect of early imaging and intervention on reducing amputation rate of diabetic foot ulcer

目的探讨糖尿病足溃疡早期影像学干预对减少截肢率的疗效。方法以2016年1月至2018年1月广东省惠州市第一人民医院手足血管外科住院部收治的89例糖尿病足溃疡患者作为研究对象,采用随机数字表法将患者分为两组,研究组(n=45)采用早期影像学干预,对照组(n=44)采用常规干预。比较两组截肢率、治疗总有效率、创面愈合和预后状况的差异。结果研究组截肢率显著低于对照组(2. 22%vs 25. 00%,χ~2=9. 895,P=0. 002)。研究组治疗总有效率显著高于对照组(97. 78%vs 75. 00%,χ~2=9. 895,P=0. 002)。研究组创面愈合率显著高于对照组,创面愈合时间显著短于对照组,差异有统计学意义(P<0. 01)。治疗后两组踝肱指数(ABI指数)均高于治疗前,且研究组高于对照组(P<0. 05,P<0. 01)。研究组溃疡复发率低于对照组,差异有统计学意义(2. 22%vs 18. 18%,χ~2=4. 602,P=0. 032)。两组均无死亡病例。结论糖尿病足溃疡早期影像学干预有利于明显减少截肢率,改善治疗效果和预后状况。

Objective To investigate the effect of early imaging and intervention(choosing the best treatment plan according to the early imaging examination) on reducing amputation rate in patients with diabetic foot ulcer. Methods Eighty-nine patients with diabetic foot ulcer,who admitted to the department of hand and foot vascular surgery of Huizhou First People’s Hospital from January 2016 to January 2018,were selected as study subjects and were randomly divided into study group(n = 45) and control group(n = 44). The early imaging and intervention was performed in study group,and the conventional intervention was performed in control group. The amputation rate,the total effective rate,wound healing and prognosis were compared between two groups. Results The amputation rate in study group was significantly lower than that in control group(2. 22% vs 25. 00%,χ~2= 9. 895,P = 0. 002),and the total effective rate was significantly higher than that in control group(97. 78% vs 75. 00%,χ~2= 9. 895,P = 0. 002). Compared with control group,the wound healing rate increased,and the wound healing time significantly decreased in study group(P< 0. 01). After treatment,the ankle brachial index(ABI) was statistically higher than that before treatment in two groups and was higher in study group than that in control group(P< 0. 05,P< 0. 01). The ulcer recurrence rate in study group was significantly lower than that in control group(2. 22% vs 18. 18%,χ~2= 4. 602,P = 0. 032). There were no deaths in both groups. Conclusion Early imaging and intervention is beneficial to reduce amputation rate,improve treatment effect and prognosis for the patients with diabetic foot ulcer.