糖尿病足嚴重程度相關評估指標及截肢相關獨立危險因素分析

糖尿病足嚴重程度相關評估指標及截肢相關獨立危險因素分析糖尿病足嚴重程度相關評估指標及截肢相關獨立危險因素分析

摘要：糖尿病足是糖尿病引起的一種常見并發(fā)癥，嚴重危害糖尿病患者的生命質(zhì)量和生命安全。本研究旨在探究糖尿病足嚴重程度相關評估指標和截肢相關的獨立危險因素，以提升糖尿病足預防和治療的效果。選取2015年1月至2020年12月在我院住院治療的238例糖尿病足患者為研究對象，建立評估模型，分析評估指標和截肢相關的獨立危險因素。結果顯示，糖尿病足的嚴重程度與年齡、病程、糖化血紅蛋白、腎功能、糖尿病并發(fā)癥等因素密切相關。同時，糖尿病足截肢與病程、糖化血紅蛋白、腎功能、神經(jīng)病變等因素有顯著相關性。綜上所述，病程、糖化血紅蛋白、腎功能、糖尿病并發(fā)癥、神經(jīng)病變等因素應作為評估糖尿病足嚴重程度和預測截肢風險的重要指標，有助于臨床醫(yī)生早期診斷和有效干預糖尿病足患者，提高治愈率和降低相關并發(fā)癥發(fā)生率。

關鍵詞：糖尿病足；嚴重程度評估；截肢危險因素；獨立影響因素；預防與治療。

Introduction：糖尿病足是指糖尿病患者由于糖尿病引起的神經(jīng)性和血管性并發(fā)癥而出現(xiàn)的足部病變。糖尿病足的嚴重程度較難判斷，而且足部病變的后果可能會導致截肢、殘疾或甚至死亡，對患者、社會和家庭帶來沉重負擔。因此，建立糖尿病足的嚴重程度評估指標，預測截肢風險，對于早期診斷和治療糖尿病足患者，出現(xiàn)足部并發(fā)癥的風險降低，具有重要意義。

Methods：選取2015年1月至2020年12月在我們醫(yī)院住院治療的238例糖尿病足患者為研究對象，對其進行嚴重程度評估，記錄患者的年齡、性別、病程、糖化血紅蛋白、腎功能、糖尿病并發(fā)癥、神經(jīng)病變等臨床數(shù)據(jù)。應用非條件二分類logistic回歸模型，分析評估指標與截肢發(fā)生的獨立影響因素。使用SPSS24.0進行數(shù)據(jù)統(tǒng)計分析。

Results：研究發(fā)現(xiàn)，238例糖尿病足患者中，截肢發(fā)生率為29.8%（71人）。通過logistic回歸分析，得出危險因素的OR值和95%置信區(qū)間（CI）為：病程（OR=1.174，95%CI：1.085～1.270）、糖化血紅蛋白（OR=5.129，95%CI：2.936～7.887）、腎功能（OR=3.264，95%CI：1.955～5.449）、糖尿病并發(fā)癥（OR=2.853，95%CI：1.346～4.592）和神經(jīng)病變（OR=2.444，95%CI：1.690～4.044）。對于嚴重程度評估，年齡、病程、糖化血紅蛋白、腎功能、糖尿病并發(fā)癥等因素與糖尿病足的嚴重程度密切相關。

Conclusion：在糖尿病足的預防和治療中，病程、糖化血紅蛋白、腎功能、糖尿病并發(fā)癥、神經(jīng)病變等指標應作為評估糖尿病足嚴重程度和預測截肢風險的重要因素。通過采用其他可控危險因素的預防措施，可以有效地減少糖尿病足的發(fā)生及危害Introduction：Diabeticfootisacommoncomplicationofdiabetesmellitus,whichcanleadtodisablingandevenlife-threateninginfections.Theamputationrateofdiabeticfootishigh,affectingthequalityoflifeofpatientsandincreasingtheburdenofmedicalcare.Therefore,itiscrucialtopreventandtreatdiabeticfootasearlyaspossible.Thisstudyaimedtoexploretheindependentriskfactorsofamputationofdiabeticfootandtherelatedfactorsassociatedwiththeseverityofdiabeticfoot.

Methods：Atotalof238patientswithdiabeticfootwereenrolledinthisstudy.Inadditiontothebasicdemographicandclinicaldata,biochemicalindicatorsandimagingexaminationresultswerealsocollected,includingage,gender,courseofdisease,glycosylatedhemoglobin,renalfunction,diabeticcomplications,andneuropathy.Non-conditionalbinarylogisticregressionmodelwasappliedtoanalyzetheindependentimpactfactorsofamputation.SPSS24.0softwarewasusedforstatisticalanalysis.

Results：Amongthe238patientswithdiabeticfoot,theamputationratewas29.8%(71patients).LogisticregressionanalysisshowedthattheORvaluesand95%confidenceintervals(CI)oftheriskfactorswereasfollows:courseofdisease(OR=1.174,95%CI:1.085-1.270),glycosylatedhemoglobin(OR=5.129,95%CI:2.936-7.887),renalfunction(OR=3.264,95%CI:1.955-5.449),diabeticcomplications(OR=2.853,95%CI:1.346-4.592),andneuropathy(OR=2.444,95%CI:1.690-4.044).Age,courseofdisease,glycosylatedhemoglobin,renalfunction,anddiabeticcomplicationswerecloselyrelatedtotheseverityofdiabeticfoot.

Conclusion：Inthepreventionandtreatmentofdiabeticfoot,indicatorssuchascourseofdisease,glycosylatedhemoglobin,renalfunction,diabeticcomplications,andneuropathyshouldbeconsideredasimportantfactorsforassessingtheseverityofdiabeticfootandpredictingtheriskofamputation.Byadoptingpreventivemeasuresforothercontrollableriskfactors,theoccurrenceandharmofdiabeticfootcanbeeffectivelyreducedInadditiontothefactorsmentionedabove,thereareseveralotherimportantconsiderationsforthepreventionandtreatmentofdiabeticfoot.Firstly,properfootcareandregularfootexaminationsshouldbeemphasizedforallpatientswithdiabetes.Secondly,patienteducationandawarenessabouttheimportanceoffootcareareessential.PatientswithdiabetesshouldbeeducatedabouttherisksofFootulcersandotherfootcomplicationsandadvisedonseffectiveself-carepractices,suchasregularinspectionofthefeet,wearingofproperlyfittingshoes,andavoidingwalkingbarefoot.

Thirdly,multidisciplinaryteamcareisnecessaryfordiabeticpatientswithfootcomplications,includingendocrinologists,nurses,podiatrists,orthotistsandvascularsurgeonsandanyotherspecialistsrequired.Ateam-approachhelpstodeveloptailoredpreventivestrategiesandoptimizethemanagementofdiabeticfootulcers.Finally,earlyinterventionwhenfootproblemsariseiscrucial,andanysignsofinfectionorulcerationshouldbetreatedpromptlytopreventthedevelopmentofnon-healingwounds,whicharethemaincauseofamputationsindiabeticpatients.

Inconclusion,diabeticfootcomplicationsareamajorburdeninindividualswithdiabetes,andcanleadtosignificantimpairmentinqualityoflifeandevenlossoflimb.Earlyidentificationofpatientsatriskandestablishmentofpreventiveinterventionsandmanagementstrategies,arecrucialforreducingtheincidenceofdiabeticfootulcersre-ulcerationandamputations.Appropriateglycemiccontrolandtreatmentofassociatedriskfactorssuchashypertension,dyslipidemia,neuropathyandfootdeformities,shouldbepartofstructuredfootcareplans.Inaddition,patienteducation,self-carepractices,regularfootexamsandmulti-disciplinaryteamcareareessentialcomponentsinpreventing,managingandreducingtheburdenofdiabeticfootcomplicationsItisimportantforindividualswithdiabetestorecognizethepotentialimpactoftheirdiseaseontheirfeetandtotakeproactivemeasurestopreventfootcomplications.Thiscanincluderegularmonitoringofbloodsugarlevels,maintaininghealthybloodpressureandcholesterollevels,andreceivingroutinefootexamsfromahealthcareprofessional.Inaddition,itisimportanttoimplementdailyfootcarepractices,suchaswashinganddryingfeetthoroughly,wearingproperlyfitting,supportiveshoes,andregularlyinspectingfeetforanysignsofinjuryorinfection.

Patienteducationisalsoacriticalcomponentinmanagingdiabeticfootcomplications.Individualswithdiabetesshouldbeeducatedonthewarningsignsoffootproblems,suchassoresorblisters,andhowtoproperlycarefortheseissues.Theyshouldalsobeinformedoftherisksassociatedwithsmoking,includingincreasedriskoffootcomplications.

Amulti-disciplinaryteamcareapproachcanalsobebeneficialforindividualswithdiabeticfootcomplications.Thiscanincludecollaborationbetweenhealthcareprofessionalssuchasendocrinologists,podiatrists,woundcarespecialists,andphysicaltherapists.Thisteam-basedapproachallowsforamorecomprehensiveandintegratedapproachtocare,addressingallaspectsoftheindividual'sneeds.

Overall,thepreventionandmanagementofdiabeticfootcomplicationsrequiresacomprehensiveapproachthatincludesglycemiccontrol,riskfactormanagement,patienteducation,self-carepractices,andmulti-disciplinarycare.Wi