影响糖尿病足创面愈合的危险因素分析

Analysis of Risk Factors Affecting Wound Healing of Diabetic Foot

目的探讨影响糖尿病足创面愈合的相关危险因素。方法选取2018年4月至2020年4月新乡市第二人民医院收治的106例糖尿病足患者作为研究对象,收集患者性别、年龄、文化程度、足背动脉搏动情况、有无合并糖尿病肾病、白蛋白水平、Wagner分级等资料,并根据负压封闭引流治疗6个月后的创面愈合情况将患者分为愈合组与未愈合组,多因素Logistic回归分析影响创面愈合的相关危险因素。结果负压封闭引流治疗6个月后,106例糖尿病足患者创面愈合81例(76.42%),设为愈合组;未愈合25例(23.58%),设为未愈合组。多因素Logistic回归分析结果显示,年龄≥60岁、足背动脉搏动减弱/消失、合并有糖尿病肾病、白蛋白<35 g/L、Wagner分级为3~5级是影响糖尿病足创面愈合的独立危险因素(95%CI为1.072~6.750、1.030~6.853、1.136~7.152、1.027~6.445、1.191~7.558,P=0.035、0.043、0.026、0.044、0.020)。结论糖尿病足创面的愈合效果与年龄、足背动脉搏动情况、有无合并糖尿病肾病、白蛋白水平、Wagner分级情况密切相关。

Objective To study the correlated risk factors affecting wound healing of diabetic foot.Methods 106 patients with diabetic foot,admitted into Xinxiang Second People’s Hospital between April 2018 and April 2020,were enrolled as research subjects,and the data were collected including sex,age,literacy level,dorsalis pedis artery pulse,with diabetic nephropathy or not,level of albumin and Wagner grading.The patients were divided into healed group and non-healed group based on the wound healing condition after 6 months of treatment with vacuum sealing drainage.Multivariate Logistic regression analysis was used to analyze the related risk factors affecting wound healing.Results After 6 months of treatment with vacuum sealing drainage,of the 106 patients with diabetic foot,81 cases(76.42%)who achieved wound healing were set as healed group,and the other 25 cases(23.58%)without achieving wound healing were set as non-healed group.Multivariate Logistic regression analysis showed that age≥60 years,weakened/disappeared dorsalis pedis artery pulse,with diabetic nephropathy,albumin<35 g/L,gradeⅢ-Ⅴof Wagner grading were the independent risk factors affecting wound healing of diabetic foot(95%CI 1.072-6.750,1.030-6.853,1.136-7.152,1.027-6.445 and 1.191-7.558,P=0.035,0.043,0.026,0.044 and 0.020).Conclusion The healing effect of diabetic foot is closely associated with patients’age,condition of dorsalis pedis artery pulse,with diabetic nephropathy or not,albumin level and Wagner grading.