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目的:通过近5年对糖尿病足病例的回顾性研究,寻找发现治疗糖尿病足中的问题并分析其原因,找出怎样规范化治疗糖尿病足的方法,为同道提供参考。方法:对2003年9月~2012年9月在本院治疗的66例糖尿病足患者病案资料回顾性研究,对其中50例进行随访研究,随访时间3个月~6年。对于保守治疗无效进行清创、植皮、截肢(截趾)处理及术后肢体功能、病灶复发、坏死面积继续扩大等问题逐步找出问题和缺陷,逐项分析原因,并根据临床经验和教训进行总结,提出规范化治疗糖尿病足的具体方案。结果:经过50例截肢(截趾)患者术后没有再次发生坏疽的44例,成功率为88%,术后继发坏疽二次截肢(截趾)2例,失败率为4%,创面感染17例,感染率为34%,其原因多数为远端微循环通道已经丧失。结论:及时发现和治理糖尿病足是问题的关键,在治疗的同时参考多学科给予的治疗意见对糖尿病足治疗及预防将会起到重要的作用。对糖尿病足远端微循环做出准确的评估会降低复发和2次手术的频率。
OBJECTIVE: Through retrospective study of diabetic foot cases in the past five years, find out the problems found in the treatment of diabetic foot and analyze its causes, find out how to standardize the method of treating diabetic foot, and provide references for the same people. Methods: A retrospective study was conducted on the medical records of 66 patients with diabetic foot treated in our hospital from September 2003 to September 2012. 50 patients were followed up for 3 months to 6 years. For the conservative treatment ineffective debridement, skin grafting, amputation (amputation) and postoperative limb function, the recurrence of lesions, the necrosis area continues to expand and other issues gradually identify the problems and defects, one by one analysis of the reasons and based on clinical experience and lessons learned To sum up, put forward a specific program of standardized treatment of diabetic foot. Results: Forty-four patients with no gangrene occurred in 50 patients with amputation (successor to toe), the success rate was 88%, secondary amputation of gangrene occurred in 2 patients (failure rate was 4%), wound infection 17 cases, the infection rate was 34%, the reason for the majority of distal microcirculation channel has been lost. Conclusion: It is the key to detect and treat diabetic foot in time. Reference to the multidisciplinary treatment advice will play an important role in the treatment and prevention of diabetic foot. Accurate assessment of distal microcirculation of diabetic foot will reduce the frequency of recurrence and 2 surgeries.