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糖尿病轻度截肢后发生重大截肢的系统和局部风险因素
Kaissar Yammine1, Youssef Jamaleddine2, Joseph Mouawad2
1Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon; Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon.
糖尿病轻度截肢带有重度截肢的重大风险,接近17%. 周围动脉疾病 (PAD) 和非MRI引导的截肢增加了这种风险,而MRI引导的程序可能会减少它.
科学领域:
- 足部外科手术 足部外科手术
- 这是血管外科手术.
- 糖尿病学 糖尿病学
背景情况:
- 糖尿病相关的脚部并发症是下肢截肢的主要原因之一.
- 大型截肢的死亡率高于小型截肢的死亡率.
- 鉴定小截肢后重大截肢的危险因素对于患者的治疗结果至关重要.
研究的目的:
- 为了量化糖尿病轻微截肢后的大型截肢的风险.
- 识别与重大再截肢相关的系统和局部风险因素.
主要方法:
- 对因糖尿病并发症而进行轻微截肢的患者进行了回顾性比较研究.
- 两组:第一组 (没有随后的截肢) 与第二组 (随后的重大截肢).
- 最少24个月的随访,分析重新截肢的频率和风险因素 (伤口愈合,茎问题,MRI指导).
主要成果:
- 在107例指数截肢中,16.8%需要随后的大型截肢.
- 周围动脉疾病 (PAD) 是主要再截肢的一个独立风险因素 (p=0.04).
- 非MRI指导的指数小截肢也是一个独立的风险因素 (p=0.02).
结论:
- 在糖尿病轻度截肢后重大截肢的风险很大 (约. 17%).17%).这是一个很大的问题.
- PAD是唯一的独立系统性因素与重大再截肢风险正相关.
- 通过MRI指导的截肢水平,靠近骨感染迹象,与重新截肢有显著的负相关性.
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