【摘要】 目的探讨糖尿病足溃疡(DFU)的诊疗方案及经验。方法分析新疆维吾尔自治区人民医院2014年1月至2015年12月间收治的403例DFU患者的病例资料,其中Wagner分级Ⅰ、Ⅱ级的DFU患者主要采用换药、局部注射胰岛素、负压封闭引流以及生物敷料覆盖等保守治疗措施;Wagner分级Ⅲ、Ⅳ、Ⅴ级的DFU患者,或合并严重双下肢动脉硬化闭塞症的患者采用手术治疗,主要包括清创、植皮、皮瓣转移修复、截肢(趾)等。结果本组患者住院期间无死亡,无严重并发症出现,其中保守治疗125例,一期清创后封闭创面者170例,采用多种方法综合治疗者108例,所有患者均创面愈合良好后出院。随访时间为10个月,随访过程中复发32例,慢性疼痛26例,并发全身多器官功能衰竭死亡2例。结论对于DFU足的治疗单一方法是难以奏效的,必须采取综合治疗的多种手段才能达到治愈创面的目的。更多还原

【Abstract】 Objective To discuss the diagnosis and treatment of diabetic foot ulcer diabetic foot ulcer( DFU) and experience. Methods From January 2014 to December 2015,all 403 patients of DFU were analysed in the People’ s Hospital of Xinjiang Uygur Autonomous Region. The patients of DFU in Wagner classificationⅠ and Ⅱ were mainly treated with wound dressing,local injection of insulin,negative pressure closed drainage and biological dressing coverage and other conservative measures. The patients of DFU in Wagner classification Ⅲ,Ⅳ and Ⅴ or combined with severe lower extremity arteriosclerosis obliterans were mainly treated with surgery,such as debridement,skin grafting,flap transfer repair,amputation( toe) and so on. Results There were no perioperative deaths and serious complications during hospitalization. Among them,there were 125 cases of conservative treatment,and 170 patients were treated with debridement,a total of 108 patients were treated with various methods. All the patients were well healed and discharged. The median follow-up was 10 months,32 patients were recurrence,26 patients were chronic pain and 2 patients were died of multiple organ dysfunction syndrome during follow-up. Conclusion A single treatment of DFU is difficult to work,a variety of means of comprehensive treatment would will have been taken to achieve the purpose of wound healing.更多还原