Transcutaneous Oxygen Pressure Measurement in Diabetic Foot Ulcers: Mean Values and Cut-Point for Wound Healing
Transcutaneous Oxygen Pressure Measurement in Diabetic Foot Ulcers: Mean Values and Cut-Point for Wound Healing
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DOI：
10.1097/won.0b013e3182a9a7bf
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发表时间：
2013-11
期刊：
影响因子：
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通讯作者：
Chuan Yang;H. Weng;Li-hong Chen;Haiyun Yang;Guangming Luo;L. Mai;G. Jin;Li Yan
中科院分区：
文献类型：
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作者：
Chuan Yang;H. Weng;Li-hong Chen;Haiyun Yang;Guangming Luo;L. Mai;G. Jin;Li Yan
目的：探讨糖尿病足溃疡患者经皮血氧分压(TcPO2)测定的均值和临界点。设计：前瞻性描述性研究。对象和地点：包括61例糖尿病和足部溃疡患者。研究地点：广州中山大学孙中山纪念医院，中国。方法：受试者在足背接受经皮氧分压(TcPO2)测量。根据临床结果分为3组：(1)溃疡愈合与皮肤完整组，(2)溃疡改善组，(3)溃疡未改善组。评估TcPO2并计算预测糖尿病足溃疡愈合的切点。结果：36例患者皮肤愈合，8例好转，17例无改善。愈合后皮肤完整的溃疡患者的平均TcPO2水平(32±10 mm Hg)显著高于改善组(30±7 mm Hg)和未愈合组(15±12 mm Hg)(P<；.001)。所有TcPo2⩽为10毫米汞柱的患者均未痊愈或足部溃疡恶化。相比之下，TcPo2≥为40毫米汞柱的所有患者伤口均闭合。仰卧位TcPO2的测定显示，25毫米汞柱是预测糖尿病足溃疡愈合的最佳临界值；使用该临界点的曲线下面积为0.838(95%可信区间=0.700-0.976)。TxPO2的敏感性为88.6%，特异性为82.4%，阳性预测值为90.7%，阴性预测值为72.2%。结论：TcPo2≥40 mm Hg与糖尿病足溃疡愈合有关，而TcPo2⩽10 mm Hg与创面愈合失败有关。我们发现，25毫米汞柱的切点最能预测糖尿病足溃疡的愈合。
PURPOSE: The purpose of this study was to investigate mean values and cut-point of transcutaneous oxygen pressure (TcPO2) measurement in patients with diabetic foot ulcers. DESIGN: Prospective, descriptive study. SUBJECTS AND SETTING: Sixty-one patients with diabetes mellitus and foot ulcers comprised the sample. The research setting was Sun Yat-sen Memorial Hospital of SunYat-sen University, Guangzhou, China. METHODS: Participants underwent transcutaneous oxygen (TcPO2) measurement at the dorsum of foot. Patients were classified into 3 groups according to clinical outcomes: (1) ulcers healed with intact skin group, (2) ulcer improved, and (3) ulcer failed to improve. TcPO2 was assessed and cut-points for predicting diabetic foot ulcer healing were calculated. RESULTS: Thirty-six patients healed with intact skin, 8 experienced improvement, and 17 showed no improvement. Mean TcPO2 levels were significantly higher (P< .001) in healed ulcers with intact skin (32 ± 10 mmHg) when compared to the improvement group (30 ± 7 mmHg) and the nonhealing group (15 ± 12 mmHg). All patients with TcPO2⩽ 10 mmHg failed to heal or experienced deterioration in their foot ulcers. In contrast, all patients with TcPO2≥ 40 mmHg achieved wound closure. Measurement of TcPO2 in the supine position revealed a cut-point value of 25 mmHg as the best threshold for predicting diabetic foot ulcer healing; the area under the curve using this cut-point was 0.838 (95% confidence interval = 0.700–0.976). The sensitivity, specificity, positive predictive value, and negative predictive value for TxPO2 were 88.6%, 82.4%, 90.7%, and 72.2%, respectively. CONCLUSION: TcPO2≥ 40 mmHg was associated with diabetic foot ulcer healing, but a TcPO2⩽ 10 mmHg was associated with failure of wound healing. We found that a cut-point of 25 mmHg was most predictive of diabetic foot ulcer healing.