Gostishchev V K, Afanas'ev A N, Khokhlov A M
Khirurgiia (Mosk). 1999(8):40-4.
The data on the results of combined treatment of 540 patients with diabetic osteoarthropathies (DOAP) complicated by pyonecrotic lesions of the feet (PNLF) are presented. The authors classification of these lesions is proposed which considers location and the stage of the disease. Surgical treatment was used in 387 (71.6%) patients. The analysis of the clinical experience in surgical treatment and the results obtained in patients with DOAP and PNLF allouvs to subdivide surgical procedures in the patients in to the following categories: 1) the initial prophylaxis of development of pyonecrotic processes; 2) measures of secondary prophylaxis of the progression of pyonecrotic processes; 3) amputation of the shin and the thigh. As a result of the complex of curative and prophylactic measures, comprizing surgical treatment, the number of favourable results of treatment in patients of the lest group increased by 24%, and the number of unfavourable outcomes decreased by 25%, the mortality rate in the test group lowered 2, 4 times.
本文介绍了540例糖尿病性骨关节炎（DOAP）合并足部脓性坏死性病变（PNLF）患者的联合治疗结果。作者提出了这些病变的分类方法，该方法考虑了病变部位和疾病阶段。387例（71.6%）患者接受了手术治疗。对手术治疗的临床经验以及DOAP和PNLF患者的治疗结果进行分析后，可将患者的手术程序分为以下几类：1）脓性坏死过程发展的初始预防；2）脓性坏死过程进展的二级预防措施；3）小腿和大腿截肢。由于包括手术治疗在内的综合治疗和预防措施，最后一组患者治疗的良好结果数量增加了24%，不良结果数量减少了25%，试验组的死亡率降低了2.4倍。
