糖尿病患者膝下截肢失败的危险因素
Itay Ron1, Shay Zvi Cherevatsky1, Amir Abu Elhija2
1The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
概括
接受膝下截肢 (BKA) 的糖尿病患者如果有血管程序或吸烟史,则面临更高的失败率. 在外科手术期间使用口服抗生素也增加了BKA衰竭的风险,进展到膝盖以上截肢 (AKA).
科学领域:
- 糖尿病的肢体救援
- 外科手术的结果
- 截肢预防 防止截肢
背景情况:
- 糖尿病并发症的膝下截肢 (BKA) 可能导致重新住院的高成本.
- 靠近截肢 (膝盖以上截肢 - AKA) 带有显著的发病率,需要对BKA进行仔细的患者选择.
研究的目的:
- 在糖尿病患者中确定BKA衰竭的风险因素,定义为AKA的进展.
- 分析与BKA失败相关的人口和临床变量.
主要方法:
- 对接受初级BKA的糖尿病患者进行了回顾性队列研究.
- 患者组的比较:成功的BKA与失败的BKA (需要AKA).
- 对人口统计数据,血管疾病,吸烟,营养状况和抗生素使用的分析.
主要成果:
- 较高的血红蛋白水平,先前的血管手术,吸烟和术后的口服抗生素使用与BKA失败有关.
- 与静脉注射抗生素相比,口服抗生素的使用与AKA的更快进展相关.
- 在失败的BKA组中,接受口服抗生素的患者比例较高 (19%),而成功的BKA组 (12%).
结论:
- 以前的血管手术和吸烟是糖尿病患者BKA衰竭的重要危险因素.
- 术后口服抗生素的使用与增加风险和更快地进展到AKA有关.
- 优化患者选择和抗生素策略可能会降低BKA失效率.
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