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目的探讨缺血性糖尿病足趾坏疽的手术处理时机。方法回顾性分析缺血性糖尿病足趾坏疽78例。根据治疗方案将病例资料分为早期手术组和延期手术组,终点性事件以手术伤口愈合时间、住院周期,住院总费用、伤口不良事件、再次手术例数为观察指标。结果延期手术组在伤口愈合时间、住院周期,住院总费用、伤口不良事件、再次手术率方面均优于早期手术组(P<0.01)。结论对于缺血性糖尿病足趾坏疽,治疗理念应当以改善患者下肢循环为主,延期对足趾坏疽进行处理,不仅能够解决感染区域的引流障碍问题,也能为下肢血液循环的改善提供充足时间,继而为术后的创面床创造了良好的微循环条件,从而加速创面的愈合,缩短治疗周期。
Objective To investigate the timing of surgical treatment of ischemic diabetic toe gangrene. Methods Retrospective analysis of 78 cases of ischemic diabetic toe gangrene. According to the treatment plan, the case data were divided into the early surgery group and the delayed surgery group. The final events were the surgical wound healing time, the hospitalization period, the total hospitalization expense, the wound adverse events and the number of reoperation as the observation index. Results The delayed operation group was better than the early operation group in wound healing time, hospitalization period, total cost of hospitalization, wound adverse events and reoperation rate (P <0.01). Conclusion For ischemic diabetic toe gangrene, the concept of treatment should be to improve the lower limb circulation in patients with mainly to delay the treatment of toe gangrene, not only to solve the problem of drainage problems in the affected area, but also to provide adequate time for lower limb blood circulation improvement , And then create a favorable microcirculation condition for the wound bed after surgery, thereby accelerating the healing of the wound and shortening the treatment period.