热带地区慢性难愈性创面流行病学调查

Epidemiological survey of chronic refractory wounds in tropical area

目的分析海南省热带气候慢性难愈性创面患者流行病学特征,论证海南省创面修复及治疗中心建设的必要性。方法回顾性分析2016年1月-2018年12月海南医学院三所附属医院慢性难愈性创面患者959例流行病学特征资料,其诊断以病案科国际疾病分类(ICD)编码为准,分析创面患者年龄、性别、致病原因、居住地、创面发生的部位、分泌物培养结果和治疗方式及转归等。结果入选患者男性604例,女性355例,男女比例为1.7∶1;其中糖尿病足508例,压疮173例。中老年患者在慢性难愈性创面中所占比例高,糖尿病足是创面的主要病因之一,其次为压疮。慢性难愈性创面发生常以下肢及骶尾部多见,约占68.6%和14.2%。以革兰阴性菌为主要感染菌,约占培养阳性标本的53.8%;创面经手术治疗愈合率为94.1%,非手术治疗愈合率为84.5%。结论通过对海南省慢性难愈性创面患者的流行病学特征进行分析,海南省在慢性难愈性创面的微生物培养、致病因素、患者治疗后的愈合率等情况具有明显的热带地域特色,其次,政府等组织有必要加强海南省创面修复治疗中心的建设,为更多的慢性难愈性患者提供诊疗的机会。

Objective To analyze the epidemiological characteristics of patients with chronic refractory wounds in tropical climate in Hainan province,and to demonstrate the necessity of building a wound repair and treatment center in Hainan province.Methods A retrospective research method was used to collect the epidemiological characteristics of the data in patients with chronic refractory wounds at three affiliated hospital of Hainan Medical College,the diagnosis was based on International Classification of Disease encoding at medical record department,then their age,gender,causes,place of residence,position of the wound,the result of culture of wound excretion and treatment and outcome were analyzed.Results There were 604 males and 355 females,with the ratio of male to female being 1.7∶1.Among them,there were 508 cases of diabetic foot disease and 173 cases of pressure ulcers.The proportion of middle-aged and elderly patients in the chronic refractory wounds was high.Diabetic foot disease was one of the main causes of the formation of chronic refractory wounds,followed by pressure ulcers.Chronic refractory wounds were most common in the lower limbs and the sacrococcygeal region,accounting for 68.6%and 14.2%,respectively.Gram-negative bacterial infection was the main infectious bacteria on the chronic refractory wounds in tropical Hainan,accounting for about 53.8%of the culture positive specimens.The healing rate of patients with wound surface was 94.1%after surgical treatment,and that of patients with non-surgical treatment was 84.5%.Conclusion Through analyzing epidemiological features of patients with chronic refractory wounds in tropical Hainan,microbial cultures,pathogenic factors,healing rate have obvious tropical region characteristic for chronic refractory wounds.Also,the government and other groups should strengthen the construction of wound repair centers in Hainan province,providing more reference for patients with chronic refractory wounds.