对糖尿病/血管疾病患者进行初级下肢截肢和再截肢之间系统风险因素的分析
Kaissar Yammine1,2,3, Joeffroy Otayek1, Emil Haikal1
1Department of Orthopedic Surgery, School of Medicine, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon.
Vascular
|August 8, 2023
概括
糖尿病足病增加了再次截肢的风险,特别是慢性病,吸烟或糖尿病加上外周动脉疾病. 识别这些因素可以帮助预测结果,并防止重复截肢.
科学领域:
- 血管外科 血管外科
- 糖尿病学 糖尿病学
- 足部医学是一门专业.
背景情况:
- 糖尿病足部并发症,包括神经病变,外围动脉疾病 (PAD) 和感染,使患者倾向于截肢.
- 糖尿病足可能导致重复截肢和增加死亡率.
- 了解重新截肢的风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 确定和评估与糖尿病足病患者再截肢率较高相关的风险因素.
- 分析下肢手术后重新截肢的独立预测因素.
主要方法:
- 进行了一项单重的回顾性比较研究.
- 分析了2011年至2021年间136名患者 (193项手术) 的数据.
- 统计方法包括t学生测试,斯皮尔曼相关性和多变量逻辑回归.
主要成果:
- 重复截肢率为大截肢的27%,小截肢的50%.
- 常见的危险因素包括糖尿病 (89%),高血压 (86.7%),PAD和冠状动脉疾病.
- 再截肢的独立预测因素是慢性病 (15%,p=0.03),吸烟 (15%,p=0.03),以及糖尿病和PAD (13.7%,p=0.05) 的综合预测因素.
结论:
- 重复截肢的重大风险因素影响血管和伤口愈合.
- 进一步的研究应该集中在开发一个分数系统来分层重新截肢风险.
- 需要结合糖尿病严重程度的预测模型,以更好地指导临床决策.
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