糖尿病足截肢者临床及康复特征对其预后影响的系统综述

Influence of clinical and rehabilitation characteristics on prognosis of diabetic foot amputees:a systematic review

目的分析糖尿病足截肢者不同临床及康复特征对其预后影响。方法检索建库至2024年8月中国知网、万方、PubMed、Cochrane Library和Google Scholar数据库的相关文献。由2名研究人员独立筛选文献和提取数据,并采用纽卡斯尔-渥太华量表(NOS)和美国卫生保健质量和研究机构推荐的评价标准进行文献质量评价,纳入中等质量以上文献,进行系统综述。结果共纳入17篇文献,涉及研究对象9239例,其中中文3篇,英文14篇;纳入研究类型为病例对照研究、队列研究和横断面研究;主要来源于康复医学、骨科学、运动医学、残疾研究等领域;发表时间在1998年至2023年。糖尿病足截肢者预后相关的临床及康复特征包括截肢水平、社会经济状况(文化程度、收入水平、社会参与等)、心理状况(焦虑、抑郁等)、生理状况(年龄、性别、疼痛、假肢使用及步行能力等)。这些特征会影响糖尿病足截肢者的生活质量,导致再截肢和死亡。结论截肢水平、社会经济状况、心理状况和生理状况均是导致糖尿病足截肢者预后不良的重要临床及康复特征因素,控制上述因素可以有效降低糖尿病足截肢者的再截肢率、死亡率,提高生活质量,改善其预后,促进其功能康复。

Objective To analyze the impact of different clinical and rehabilitation characteristics on the prognosis of diabetic foot amputees.Methods Related literatures were searched in CNKI,Wanfang Data,PubMed,Cochrane Library and Google Scholar from establishment to August,2024.The literatures were screened and extracted by two researchers independently,the Newcastle-Ottawa Scale(NOS)and the evaluation criteria recommended by Agency for Healthcare Research and Quality(US)were used for quality evaluation,and literatures with above medium quality were included,and a systematic review was conducted.Results A total of 17 articles involving 9239 subjects were included,in which three were Chinese,and 14 were English.The study designs were case-control study,cohort study and cross-sectional study.They mainly came from the fields of rehabilitation medicine,orthopedics,sports medicine and disability studies,and were published between1998 to 2023.Clinical and rehabilitation characteristics related to the prognosis of diabetic foot amputees includedamputation level,socioeconomic determinants(educational attainment,economic status,social participation,etc.),psychological states(anxiety,depression,etc.)and physiological factors(age,gender,pain,prosthetic limbusage,and ambulatory capacity,etc.).These different characteristics could affect the quality of life of diabeticfoot amputees,and even lead to re-amputation or death.Conclusion Factors of amputation level,socioeconomic status,psychological status and physiological status are importantfor poor prognosis in diabetic foot amputees.Controlling the above factors can effectively reduce the re-amputationrate and mortality,and improve the quality of life in diabetic foot amputees,thus improving their prognosis,and promoting functional rehabilitation.