尼日利亚某高等教育机构中糖尿病导致的肢体丧失程度

A. Yusuf, A. Adedire, A. Ala, S. Olanrewaju
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引用次数: 0

摘要

背景:糖尿病及其并发症继续对健康和财务稳定构成巨大挑战。糖尿病仍然是国家和全球经济负担的来源。最近观察到糖尿病足溃疡(DFU)的发病率;糖尿病的并发症之一,正在增加,它对糖尿病患者的经济损失、发病率和死亡率造成了巨大影响。这对受影响的个人造成了巨大的损失,包括治疗费用、持续的畸形、入院期间失去的工作/生产天数及其随之而来的经济影响,以及最终记录的死亡人数。目的是确定在高等院校12个月内糖尿病导致的肢体损失或下肢截肢的程度,并评估患者的临床特征。方法:这是一项回顾性研究,对过去12个月内在尼日利亚西南部奥索博的UNIOSUN教学医院连续预订下肢截肢并进行手术的所有患者的记录进行了回顾性研究。在这些总数中,提取DFU病例组成另一个研究组,然后进行详细研究。结果:自2021年7月至2022年5月,共有38名患者接受了下肢截肢手术。截肢总人数中有23人患有DFU,占60.5%,其次是道路交通事故,占28.9%(n=11)。在23例糖尿病病例中,女性15例,M:F比为1:1.9。平均年龄63±11.18岁。糖尿病的平均病程为8.06±5.64年。78.3%的患者没有接受过足部护理教育,多普勒超声证实100%的患者患有动脉粥样硬化。最常见的分离细菌是变形杆菌34.8%。住院时间在6周到16周之间。入院结果基本成功,95.7%的患者出院,4.3%的患者死亡。结论:DFU对发病率和死亡率有显著影响。糖尿病持续时间长、PAD和DPN的存在以及年龄的增长和伤口感染变形菌被认为是与坏疽性DFU相关的危险因素。然而,还需要更大规模的研究来确定这些因素作为DFU患者截肢的预测因素。大部分患者出院后,治疗效果良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Magnitude of limb loss attributable to diabetes mellitus in a tertiary institution in Nigeria
Background: Diabetes mellitus (DM) and its complications, continues to pose enormous challenge to health and financial stability.  Diabetes has remained a source of national and global economic burden. It has been observed lately that incidence of diabetic foot ulcer  (DFU); one of the complications of DM, is on the increase and it is contributing hugely to financial loss, morbidity and mortality among  diabetic patients. This is taking a great toll on affected individuals in terms of cost of treatment, deformities sustained, number of  working/productive days lost while on admission and its attendant economic implications, and ultimately mortalities recorded. The aim  was to determine the magnitude of limb loss or lower extremity amputation attributable to DM over a period of 12 months in tertiary  institution and to assess the clinical profile of the patients. Method: This is a retrospective study of the records of all patients that were  consecutively booked for lower limb amputation and operated upon in the last 12 months at UNIOSUN Teaching Hospital, Osogbo, South-Western Nigeria. Out of these total, cases of DFU were extracted to form another study group and then studied in detail. Results:  Atotal of 38 patients had lower limb amputation from July 2021 to May 2022. Twenty three of the total number of amputations had DFU  with a huge proportion of 60.5%, followed by road traffic accident with 28.9% (n=11) Of the 23 diabetic cases , females were 15 with M:F  ratio of 1:1.9. Mean age was 63±11.18 years. Mean duration of DM was 8.06±5.64 years. 78.3% had no foot care education and Doppler  USS confirmed atherosclerosis in 100% of the patients. The commonest bacteria isolated was Proteus 34.8%. Length of hospital stay  ranged between 6 weeks to 16 weeks. Outcome of admission was largely successful with 95.7% discharged and 4.3% mortality.   Conclusion: DFU contributes markedly to morbidity and mortality. Long duration of DM, presence of PAD and DPN as well as  advancement in age and wound infection with proteus bacterial are observed to be risk factors associated with gangrenous DFU.  However, larger studies are needed to establish these factors as predictors of amputation in patient with DFU. Outcome was majorly  good as majority of the patients were discharged. 
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