糖尿病足不可逆性坏疽影响因素的研究

Study on influencing factors of irreversible gangrene in diabetic foot

目的探讨糖尿病足(DF)不可逆性坏疽(IG)的影响因素。方法回顾性纳入DF患者155例,根据IG情况分为无IG组(95例)和IG组(60例),再根据造成IG的主要原因将IG组分为干性不可逆性坏疽(DIG)组(20例)和湿性不可逆性坏疽(WIG)组(40例)。比较各组间的临床资料及DF局部特征。采用二分类logistic回归分析分别探究DF患者发生IG、DIG、WIG的影响因素。结果更高的ABI(OR=0.028,95%CI 0.006~0.134,P<0.001)是DF患者发生IG的独立保护因素,更深的感染深度(OR=4.648,95%CI 2.115~10.212,P<0.001)、更大的创面表面积(OR=1.581,95%CI 1.003~2.493,P=0.049)为其独立危险因素。更高的ABI(OR=0.022,95%CI 0.003~0.171,P<0.001)是DF患者发生DIG的独立保护因素,更大的创面表面积(OR=1.861,95%CI 1.078~3.212,P=0.026)为其独立危险因素。更高的ABI(OR=0.027,95%CI 0.004~0.203,P<0.001)是DF患者发生WIG的独立保护因素,更深的感染深度(OR=25.517,95%CI 4.653~139.940,P<0.001)为其独立危险因素。结论DF局部特征(血供、感染深度、创面表面积)是DF患者发生IG的重要影响因素。

Objective To explore the influencing factors of irreversible gangrene(IG)in diabetic foot(DF).Methods A total of 155 patients with DF were included retrospectively and divided into non-IG group(95 cases)and IG group(60 cases)according to IG situation.IG group were divided into dry irreversible gangrene(DIG)group(20 cases)and wet irreversible gangrene(WIG)group(40 cases)according to the main couse of IG.The clinical materials and DF local characteristics were compared among groups.Binary logistic regression analysis was used to explore the influencing factors of IG,DIG and WIG in DF patients.Results Higher ABI(OR=0.028,95%CI 0.006-0.134,P<0.001)was an independent protective factor for IG,while deeper infection depth(OR=4.648,95%CI 2.115-10.212,P<0.001)and larger wound surface area(OR=1.581,95%CI 1.003-2.493,P=0.049)were independent risk factors for IG.Higher ABI(OR=0.022,95%CI 0.003-0.171,P<0.001)was an independent protective factor for DIG,while larger wound surface area(OR=1.861,95%CI 1.078-3.212,P=0.026)was the independent risk factor for DIG.Higher ABI(OR=0.027,95%CI 0.004-0.203,P<0.001)was an independent protective factor for WIG,while deeper infection depth(OR=25.517,95%CI 4.653-139.940,P<0.001)was an independent risk factor for WIG.Conclusion Local characteristics(circulation,infection depth,wound surface area)of DF were important influencing factors of IG.