一例难治性糖尿病足的诊治经验

Experience in Diagnosis and Treatment of a Refractory Diabetic Foot Ulcer

本文报道2017-10-06海南省人民医院收治的1例54岁糖尿病足患者的诊疗过程,患者足后跟大面积破溃,内分泌科在给予控制血糖、抗感染及改善全身营养状况的同时,行清创术,并利用封闭式负压引流术、自体富血小板凝胶及微动力负压敷料成功治愈该患者。糖尿病足是特殊的慢性创口,易感染且难愈合,是临床上治疗的难点,且溃疡累及足跟部的治疗更加棘手。本科室的诊治经验是首先充分做好患者全身情况评估,改善全身情况与清创同时进行;其次最重要的是在不同的治疗时期根据创口愈合的不同需求,针对性地选择相应的治疗手段,以取得最佳治疗效果。

A case of a 54-year-old patient with diabetic foot ulcer and a large area of heel ulceration admitted by Hainan General Hospital on October 6,2017 was reported.Debridement was performed by controlling blood sugar,giving antiinfection therapy and improving the nutritional status of the whole body.The patient was successfully cured by vacuum sealing drainage,autologous platelet-rich gel and micro-dynamic vacuum pack dressings.Diabetic foot ulcer,as a special chronic wound,is easy to be infected and difficult to heal in clinical treatment.Among them,ulcerations involving the heel are often more difficult to treat.Our experience was to do a good job firstly in the assessment of the overall situation of the patient because the improvement of the overall nutritional status and debridement were carried out simultaneously.Secondly,the most important thing was to select the appropriate treatment methods according to different needs of wound healing in different treatment periods to achieve the best therapeutic effect.