糖尿病足溃疡的综合治疗73例临床观察

Comprehensive treatment of diabetic foot ulcers

目的总结糖尿病足溃疡的治疗方法。方法选择2007年8月至2014年2月航天中心医院73例糖尿病足溃疡患者在控制血糖、抗感染、改善循环、营养神经等基础治疗情况下,进行介入手术改善下肢动脉供血,并积极的创面处理。结果糖尿病足溃疡患者WagnerⅠ级26例及Ⅱ级19例全部愈合;Ⅲ级共15例有12例愈合,3例好转;Ⅳ级共8例有3例愈合,2例好转,2例截趾,1例自动出院;V级共5例有3例最终截肢,术后恢复良好,1例因感染加重而死亡,1例自动出院。总有效率为89.0%,治愈率为82.2%,截肢率为6.8%,病死率1.4%。结论全身综合治疗为基础,正确判断并处理糖尿病足创面,及时给予下肢动脉循环重建,可以减少糖尿病足的致残率,降低截肢率。

Objective To summarize the treatment of diabetic foot ulcers. Methods From August 2007 to February 2014, 73 cases with diabetic foot ulcers of aerospace center hospital were treated by controlling blood sugar, anti-infection, improving basic cycle, neurotrophic growth, etc. Interventional surgery to improve lower extremity artery and active ulcer treatment. The results Diabetic foot ulcers in patients with Wagner grade Ⅰ 26 cases and grade Ⅱ 19 cases healed, grade Ⅲ 15 cases, 12 cases healed, 3 cases improved, grade Ⅳ 8 cases, 3 cases healed, 2 cases improved, 2 cases cutted toe, 1 case discharged, grade V 5 cases, 3 cases eventually amputated, postoperative recovery was good, 1 case of death due to infection increased, 1 case discharged. The total effective rate of 89.0%, the cure rate was 82.2%, amputation rate was 6.8%, the mortality rate of 1.4%.Conclusion Systemic treatment as the basis, the right to judge and deal with diabetic foot wounds, timely reconstruction of lower extremity arterial circulation, can reduce morbidity and reduce amputation rates of diabetic foot.