A CLINICOPATHOLOGICAL STUDY OF DIABETIC FOOT ULCERS
A CLINICOPATHOLOGICAL STUDY OF DIABETIC FOOT ULCERS
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DOI：
10.1111/j.1464-5491.1987.tb00912.x
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发表时间：
1987-09-01
影响因子：
3.5
通讯作者：
JEFFCOATE, WJ
中科院分区：
文献类型：
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作者：
JONES, EW;PEACOCK, I;JEFFCOATE, WJ
在 32 个月的时间里，54 名年龄在 38-90 岁（平均 64 岁）的糖尿病患者的 94 例足部溃疡在足部专科诊所接受治疗。百分之五十六是男性，而且他们比女性年轻得多； 46% 正在服用胰岛素。糖尿病的平均病程为 13.4 年。与对照组比较显示，视网膜病变（60% vs 23%）、神经病变（89% vs 31%）、血管病变（71% vs 34%）、动脉钙化（31% vs 20%）和既往病变（54% vs 4%）的患病率较高（p<0.01）。糖尿病控制质量或吸烟习惯没有差异。使用了简单的病变分类。所有类型均产生微生物混合培养物（平均每拭子 2.1 个）；获得的菌群受到全身抗生素的影响。异常压力被认为是导致愈伤组织区域发生所有病变的原因。此外，在所有其他类型中，高达 60% 的事件是由可确定的创伤引发的。在研究期结束时，愈伤组织区域的病变更有可能愈合，但平均愈合时间明显长于其他病变。尽管有大量的门诊支持，但在 974 天的时间里，33 名患者总共住院 1188 天，平均每位患者住院 36 天，每天使用 1.2 张床位。迫切需要进一步研究来确定预防和治疗糖尿病足溃疡的最佳方法。
During a 32‐month period 94 foot ulcers in 54 diabetic patients aged 38–90 years (mean 64 years) were managed in a specialist foot clinic. Fifty‐six percent were men, and they were significantly younger than women; 46% were taking insulin. Mean duration of diabetes was 13.4 years. Comparison with controls revealed a higher prevalence (p<0.01) of retinopathy (60% vs 23%), neuropathy (89% vs 31%), vasculopathy (71% vs 34%), arterial calcification (31% vs 20%) and previous lesions (54% vs 4%). There was no difference in quality of diabetic control, or smoking habit. A simple classification of lesions was used. All types yielded mixed cultures of microorganisms (average 2.1 per swab); the flora obtained was affected by systemic antibiotics. Abnormal pressure was judged to have contributed to all lesions occurring in areas of callus. In addition definable trauma precipitated the event in up to 60% of all other types. Lesions in areas of callus were more likely to have healed by the end of the study period, but average time to healing was significantly longer than other lesions. Despite intensive outpatient support, 33 patients spent a total of 1188 days in hospital during the 974 day period, an average of 36 days per patient and 1.2 beds per day. Further research is urgently required to define optimal methods of prevention and treatment of diabetic foot ulcers.