糖尿病足患者主要截肢的危险因素

University of Thi-Qar Journal of Medicine Pub Date : 2019-08-02 DOI:10.32792/utq/utjmed/17/1/4

M. Mahdi, Ihsan Oudah Yasir

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引用次数: 1

摘要

目的:本研究旨在探讨与糖尿病足患者大截肢危险因素相关的临床和实验室因素。专利、材料和方法:这是2013年11月至2016年6月在巴士拉综合医院进行的横断面研究。对100名糖尿病足患者的病程、糖尿病类型、社会经济状况、吸烟史、截肢史、视网膜病变、肾病、神经病变、心脏病、足部畸形进行评估。根据Wagner分类对足部溃疡进行分类，多普勒研究评估足部缺血，基线实验室检查包括Hb%、WBC、ESR、空腹血糖、Hb A1c、尿素、血清肌酐、血清白蛋白、心电图、胸片。结果:男性、年龄>60岁、肾病、视网膜病变、神经病变、足部畸形、截肢史、糖尿病病程>15年、低社会经济状况、Hb 80、Hb A1c>8%、血清白蛋白6、高Wagner评分等与糖尿病足主要截肢风险相关的危险因素。结论:Wagner 4级和5级是大截肢的主要独立危险因素。白细胞计数不能很好地预测糖尿病足的严重程度。可以为每位患者安排评分系统，根据评分系统做出适当的截肢和保守治疗决策。表1:糖尿病足评分系统编号危险因素评分1男性性别12年龄> 60岁13糖尿病病程> 16岁1 4瓦格纳分级4和5各1例吸烟16低社会经济状况17神经病变18肾病19视网膜病变1 10心脏病1 11既往截肢1 12足部畸形1 13 Hb80 1 18多普勒评分>6 1 19总分23

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Risk Factors For Major Amputation In Diabetic Foot Patients

Objectives : this study to identify the clinical and laboratory factors associated with the risk factors of major amputation in diabetic foot patients. Patents, materials and method: this is cross sectional study carried out in Basra general hospital between November 2013 to June 2016. 100 diabetic foot patients evaluated for duration of the illness, type of diabetes, socioeconomic state, smoking history, previous amputation, retinopathy, nephropathy, neuropathy, cardiac disease, foot deformities. The foot ulcers were classified according to Wagner classification, foot ischemia was assessed by Doppler study, baseline laboratory investigations done include Hb%, WBC, ESR, Fasting blood sugar, Hb A1c, blood urea, serum creatinine, serum albumin, ECG, Chest x-ray. Results: number of risk factors found to be associated with risk of major amputation in diabetic foot patient include male sex, age>60 years, nephropathy, retinopathy, neuropathy, foot deformity, previous amputation, duration of diabetes >15 years, low socioeconomic state, Hb 80, Hb A1c>8%, serum albumin 6, high Wagner score. Conclusion: Wagner grade 4 and 5 are the major independent risk factor for major amputation. WBC count is poor predictor for the severity of diabetic foot. Scoring system can be arranged for each patient according which appropriate decision can be made amputation and conservative treatment. Table 1: Diabetic Foot Scoring System Number Risk factor score 1 Male sex 1 2 Age > 60 year 1 3 DM duration > 16year 1 4 Wagner grade 4 and 5 One for each 5 Smoking 1 6 Low socioeconomic state 1 7 Neuropathy 1 8 Nephropathy 1 9 Retinopathy 1 10 Cardiac disease 1 11 Previous amputation 1 12 Foot deformities 1 13 Hb<10gm/dl 1 14 Albumin level<2.5gm/dl 1 15 Fasting blood sugar 1 16 Doppler score 1 17 ESR>80 1 18 Doppler score >6 1 19 Total score 23

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University of Thi-Qar Journal of Medicine

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