患有和没有外周动脉疾病的患者的糖尿病足骨髓炎:两个不同的疾病?
Marco Meloni1,2, Ermanno Bellizzi1,2, Aikaterini Andreadi1,2
1Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
The international journal of lower extremity wounds
|July 21, 2024
概括
患有糖尿病足骨髓炎 (DFO) 的患者的外周动脉疾病 (PAD) 会导致更长的愈合时间和轻微截肢,住院和重新干预的风险增加. 然而,PAD不会影响DFO的整体愈合率.
科学领域:
- 整形外科 整形外科 整形外科
- 血管外科 血管外科
- 糖尿病学 糖尿病学
背景情况:
- 糖尿病足骨髓炎 (DFO) 是糖尿病的一种严重并发症,通常需要复杂的管理.
- 周围动脉疾病 (PAD) 是糖尿病患者常见的并发症,可能会影响DFO的结果.
- 了解PAD对DFO治疗的影响对于优化患者护理至关重要.
研究的目的:
- 为了比较前脚DFO在患有和没有外周动脉疾病 (PAD) 的患者的结果.
- 确定PAD是否是DFO患者不良结果的独立预测因素.
- 评估PAD对愈合率,截肢率,住院和重新干预需求的影响.
主要方法:
- 对166名前脚DFO患者进行前性研究,接受了保守的外科除菌和抗生素治疗.
- 患者被分为两组:神经缺血性DFO (有PAD) 和神经病性DFO (没有PAD).
- 包括愈合,愈合时间,截肢率,住院和手术重新干预在内的结果在1年后被评估.
主要成果:
- 患有神经缺血性DFO的患者年龄较大,糖尿病持续时间较长,透析和缺血性心脏病发病率较高.
- 虽然愈合率相似 (96.5% vs 97.5%),神经缺血性DFO的愈合时间较长 (7.8 vs 5.7周).
- 神经缺血性DFO的轻微截肢 (16.1%对3.8%),住院 (90.8%对51.9%) 和手术重新干预 (14.9%对8.8%) 的比例显着更高.
- PAD是轻微截肢,住院和手术重新干预的独立预测因素.
结论:
- 周围动脉疾病 (PAD) 显著影响糖尿病足骨髓炎 (DFO) 的管理和结果.
- 患有PAD的DFO患者经历了延长的愈合时间和轻微截肢和住院的可能性增加.
- PAD是DFO中不良结果的独立风险因素,强调需要全面的血管评估和管理.
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