单中心糖尿病足规范化专科治疗后的疗效变化.docVIP

第36卷 2015年第6期 第36卷 2015年 第6期 11月 Vol.36 No.6 Nov. 2015 JOURNAL OF SUN YAT-SEN UNIVERSITY(MEDICAL SCIENCES) 单中心糖尿病足规范化专科治疗后的疗效变化 麦梨芳，李永洁，王 川 ， 杨 川，刘 丹 ， 张 少 玲 ， 严 励 (中山大学孙逸仙纪念医院内分泌科，广东广州510120) 摘 要：【目的】评价实施糖尿病足规范化专科治疗方案对糖尿病足患者的疗效(包括住院时间及截肢率)。【方法】回顾 自2004年到2010年间我科收治的361名患者，以2008年开始采取规范化专科治疗为时间界点分为两组，统计并对比两组 患者一般情况和住院相关检查结果、住院时间及截肢率；以Wagner分级对糖尿病足溃疡的严重程度进行评估。【结果】两组 患者在年龄、糖尿病病程、BP、BMI、WHR、FBG、PBG、HbA1c等检查结果无统计学差异，合并糖尿病慢性并发症的情况也无差 别。2008年后实施规范化治疗后，下肢血管介入治疗(30.77% vs 3.35%,P0.05)、减压鞋的使用(47.25% vs 7.82%,P0.05) 以及新型辅料的应用增加；两组的治疗转归不同：平均住院时间有明显的缩短(24.9±1.8 vs 17.5±1.3,P0.05),截肢率明 显下降(18.44% vs 8.79%,P0.001),大截肢率明显下降(10.61% vs3.84%,P0.001)。 【结论】糖尿病足规范化专科治疗，包 括进行全身治疗、局部伤口的评价与处理，以及发挥外科清创和血管腔内介入治疗的作用，可以提高治疗效果，缩短患者住 院时间，降低截肢率。 关键词：糖尿病足；截肢；治疗；转归 中图分类号：R587.1 文 献 标 志 码 ：A 文章编号：1672-3554(2015)06-0900- 06 Hospital Outcomes of Diabetic Foot Improves after Standardized Management Complying with the International Guideline MAI Li-fang,LI Yong-jie, WANG Chuang, YANG Chuang, LIU Dan, ZHANG Shao-ling, YAN Li (Department of Endocrinology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, 510120, China) Corresponding to: ZHANG Shao-ling, E-mail;zhangshaoling88@ Abstract:【Objective】To compare the hospital outcome after conducing standardized management procedure complying with the international guideline(IDF2007) on diabetic foot.【Methods】We conducted standardization of management according to guideline of IDF from the year of 2008.Using 2008 as a cut point, all the subjects suffered from diabetic foot were grouped in two separate groups 2004-2007 and 2008-2010. Clinical features were recorded including sex,age, body mass index, severity of hypertension, diabetic duration, fasting blood glucose at admission, HbAlc, lipid profiles and the concomitant complications. Wagner staging system was used to evaluate the severity of diabetic foot ulcer. Major managements were recorded. Hospital outcomes including hospitalized days and amputation rates were