跨学科的方法中脚Charcot神经骨关节病:一个案例系列
Marijn Stelwagen1, Wilbert van Laar1, Boudewijn Borger van der Burg2
1Department of Orthopaedic Surgery, Alrijne Ziekenhuis, Leiderdorp, The Netherlands.
Foot & ankle specialist
|April 26, 2025
概括
对于Charcot神经骨关节病 (CNO) 的修复性足部手术可以预防截肢. 一种多学科的方法优化高血糖,感染,压力和血液流动导致大多数患者的无,功能结果.
科学领域:
- 整形外科 整形外科 整形外科
- 糖尿病人的足部护理
- 血管外科 血管外科
背景情况:
- 查科特神经骨关节病 (CNO) 可能导致足部形,导致和截肢风险增加.
- 周围动脉疾病 (PAD) 和糖尿病复杂化了CNO患者的治疗结果.
研究的目的:
- 评估修复性足部手术 (RFS) 在治疗中脚CNO的有效性.
- 评估多学科协议对CNO患者的愈和截肢预防的影响.
主要方法:
- 从2019年到2023年,回顾17名中脚CNO患者的病例系列,他们接受了RFS治疗.
- 治疗方案的重点是优化高血糖,感染控制,减压和动脉血流.
- 多学科团队管理,包括手术,内分泌和血管护理.
主要成果:
- 94%的患者在没有截肢的情况下实现了无的植物级脚.
- 88%的患者患有糖尿病,80%的患者在治疗后恢复正常HbA1c水平.
- 4名患者 (24%) 患有PAD,2名患者需要重新血管化;24%的患者患有深度感染,35%需要进一步手术.
结论:
- 当RFS与多学科方法相结合时,可以有效地实现中脚CNO的无和功能性结果.
- 这一策略成功地预防了CNO的高风险糖尿病患者的截肢.
- 优化血流和血糖控制等关键因素对于成功的CNO治疗至关重要.
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