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目的总结糖尿病足的临床特点,分析预后。方法选择2013年9月至2015年9月住院治疗92例糖尿病足患者,按Wagner不同分级分组,对比各组患者入院时的一般情况、检查结果,记录患足创面3个月愈合率,分析不愈合原因。结果不同Wagner分级患者,年龄、糖尿病病程、糖尿病足溃疡持续时间、糖化血红蛋白、踝肱指数、血高密度脂蛋白、慢性肾脏病(CKD)3期以上比较,组间差异无统计学意义(P>0.05)。Wagner1级组创面持续时间较Wagner(2~5级)组短(P<0.05)。白细胞计数、C反应蛋白、血浆纤维蛋白原、血沉数值随着Wagner分级增加逐渐升高,血红蛋白、白蛋白、血胆固醇、血甘油三酯随着Wagner分级的增加逐渐降低,各组间差异有统计学意义(P均<0.05)。不同Wagner分级患足3个月愈合率组间差异有统计学意义(P<0.05)。结论可以由炎性和营养状态指标结合糖尿病足溃疡Wagner分级,评估患足感染、坏疽情况。患足血供和足部坏疽程度决定了患足的预后。
Objective To summarize the clinical features of diabetic foot and analyze the prognosis. Methods Ninety-two patients with diabetic foot were selected from September 2013 to September 2015. The patients were divided into different groups according to Wagner’s classification. The general conditions of patients admitted to hospital were compared. The results were recorded and the healing rate of wounds at 3 months was recorded. Healing reasons. Results There was no significant difference between the three groups in Wagner grade, age, duration of diabetes, duration of diabetic foot ulcers, glycosylated hemoglobin, ankle brachial index, blood HDL, CKD (P> > 0.05). The Wagner level 1 wounds had a shorter duration (P <0.05) than Wagner (grade 2 to 5). The values of white blood cell count, C reactive protein, plasma fibrinogen and erythrocyte sedimentation rate increased with the increase of Wagner grade, hemoglobin, albumin, blood cholesterol and triglyceride decreased gradually with the increase of Wagner grade Significance (P <0.05). The Wagner graded 3-month healing rate was significantly different between groups (P <0.05). Conclusion The inflammatory and nutritional status indicators combined with diabetic foot ulcer Wagner classification, assessment of foot infection, gangrene situation. Suffering from foot blood supply and foot gangrene degree determines the prognosis of foot disease.