一个系统的审查和对糖尿病脚中部分脚截肢的元分析
Samantha H Greenfield1, Gargi M Samarth1, Alison H McGregor2
1Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, United Kingdom.
Journal of vascular surgery
|November 13, 2025
概括
糖尿病成年人的部分脚截肢 (PFAs) 有高的再截肢率和延迟愈合. 仔细的患者沟通和标准化的术后护理对于改善结果至关重要.
科学领域:
- 足部外科手术 足部外科手术
- 糖尿病脚并发症 糖尿病脚并发症
- 肢体救援程序 肢体救援程序
背景情况:
- 部分脚截肢 (PFAs) 是糖尿病患者晚期脚病的节能肢体替代方案.
- 这些手术旨在维护功能,避免严重的截肢.
研究的目的:
- 系统地审查PFAs在成人糖尿病患者的临床结果.
- 分析大/小重截肢率,伤口愈合,再以及死亡率.
主要方法:
- 按照PRISMA指南进行系统审查.
- 在MEDLINE和Embase数据库中搜索了接受PFA的糖尿病患者的研究.
- 包括46项研究 (32,496名患者);使用ROBINS-I工具评估偏差风险.
主要成果:
- 主要截肢率根据PFA类型有所不同:0-10% (指甲/四足),8-54% (TMA),11-44% (中脚). 总体估计的利率:23%.
- 观察到很高的异质性 (I2 = 90%). 轻微的重新截肢率:12-33%.
- 一年死亡率:16% . 伤口愈合延迟和再的高率 (在TMA后高达69%).
结论:
- 糖尿病患者的PFA具有重新截肢,延迟愈合和肢体损失的重大风险.
- 在共享决策中强调风险沟通,并标准化术后护理.
- 多学科方法和结构化康复可以改善结果;需要进一步研究优化护理.
相关概念视频
Peripheral Artery Disease IV: Nursing Management
329
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
329
Peripheral Artery Disease V: Postoperative Nursing Management
360
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
360
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
339
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
339


