影响糖尿病慢性并发症及足溃疡发生高危因素探讨研究.docVIP

影响糖尿病慢性并发症及足溃疡发生高危因素探讨研究 　　【摘 要】目的 探讨糖尿病足（DF）的临床特点及影响足溃疡发生的危险因素。方法 回顾性研究300例DF患者的临床特点，并用Logistic多元回归分析影响足溃疡发生的危险因素。结果 随着年龄、病程增加，DF的发病率呈上升趋势。Logistic多元回归分析显示，痛觉、温度觉、振动觉、自主神经功能及踝肱指数（ABI）水平与DF的发生密切相关。大多数足溃疡（57.1%）是由日常生活中一些可以避免的细节原因所诱发。随着Wagner分级的增加，DF患者的平均住院时间和平均住院费用逐渐增加，足溃疡的愈合情况越来越差，且各组间差异有统计学意义（P0.05），截肢率也逐渐升高。结论 加强对糖尿病患者神经病变、血管病变的筛查和足溃疡高危人群的教育，对预防足溃疡的发生意义重大，尽早科学治疗可减少医疗费用和避免截肢。 　　【关键词】糖尿病足；溃疡危险因素 　　【Abstract】 Objective To study the clinical characteristics and risk factors of diabetic foot ulceration（DF）.Methods The clinical characteristics of 300 DF patients were retrospectively studied. Logistic multiple regression analysis was used to screen the 　　risk factors of foot ulceration.Results The incidence of diabetic foot 　　rose along with the increases of age and duration. Logistic multiple 　　regression analysis exhibited that pain，temperature sensation，vibration sensation，autonomic nerve function and ABI were 　　Closely related with the occurrence of diabetic foot .Most of the incentives of foot ulcers（57.1%）were from patients and relatives paying no attention to the details in daily life，which can be completely avoided. 　　With the increase of Wagner grade，the length and the cost of hospitalization gradually increased，the healing situations of foot ulcers became worse，with statistically significant differences among 　　groups（P0.05），and amputation rate gradually increased .Conclusions 　　For reducing medical costs and avoiding amputation，it is of a great 　　significance to strengthen the screening of diabetic neuropathy and vasculopathy for diabetic patients and to enhance the education for diabetic patients at high risk for foot ulceration so as to prevent the 　　occurrence of DF and to treat scientifically as soon as possible . 　　【Key words】 Diabetes mellitus；Diabetic foot；Risk factor 　　糖尿病足（DF）是DM 的常见而严重的慢性并发症之一，是指与下肢远端神经异常和外周血管病变相关的足部感染、溃疡和（或）深层组织破坏[1]，最常见的后果是慢性溃疡，最严重的结局是截肢甚至死亡，而且治疗周期长，医疗费用高，给患者带来极大痛苦及沉重的负担[2]。因此，寻找科学的预防和治疗DF的方法已成为当今的一项重要课题。 　　1对象与方法