与糖尿病足部感染中脚截肢失败相关的危险因素
Gerardo Víquez-Molina1, Javier Aragón-Sánchez2, Mariana Villalobos-Vargas3
1Diabetic foot Unit, San Juan de Dios Hospital, San José, Costa Rica.
The international journal of lower extremity wounds
|October 27, 2023
概括
糖尿病足部感染截肢失败是常见的,影响大约三分之一的患者. 严重的感染,特定的细菌如大肠杆菌和P. aeruginosa,以及延长的前列血时间增加了失败的风险. 肥胖和更高的血红蛋白水平可能会降低失败的风险.
科学领域:
- 足部医学是一门专业.
- 传染性疾病 传染性疾病
- 内分泌学 在内分泌学.
背景情况:
- 糖尿病足部感染是致病率和肢体损失的重要原因.
- 指甲截肢是一种常见的初始手术干预,用于中度至重度的糖尿病足部感染.
- 了解预测截肢失败的因素对于优化患者的治疗结果和防止进一步的手术干预至关重要.
研究的目的:
- 确定与糖尿病和足部感染患者的食指截肢失败相关的临床和微生物学因素.
- 为了确定截肢失败的患病率及其相关风险因素在这个患者群体.
主要方法:
- 对175名因中度至重度脚部感染而住院的糖尿病患者进行了回顾性队列研究,这些患者经历了食指截肢切断.
- 普森回归模型被用来计算相关因素的流行率 (PR) 和95%置信区间 (CI).
- 对年龄和性别进行了调整的多变量分析,以确定截肢失败的显著预测因素.
主要成果:
- 大约30.3%的患者经历了指甲截肢后的失败,需要更多的近端手术.
- 与更高的失败率相关的显著因素包括严重感染 (PR: 1.78),大肠杆菌感染 (PR: 2.21), Pseudomonas aeruginosa 感染 (PR: 2.11) 和延长的前列血时间 (PR: 1.13).
- 肥胖 (PR:0.58) 和血红蛋白水平升高 (PR:0.92) 与截肢失败的患病率较低有关.
结论:
- 对糖尿病脚部感染的指指脚截肢的失败率很高,这凸显了需要仔细选择和管理患者的必要性.
- 特定病原体 (大肠杆菌,P. aeruginosa) 的感染,严重的感染表现和凝血病 (延长的前血栓时间) 是潜在手术失败的关键指标.
- 相反,肥胖和更高的血红蛋白水平可能会对截肢失败产生保护作用,这需要进一步研究它们的潜在机制.
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