Suppr超能文献

比利时北部弗拉芒地区的糖尿病足项目:《圣文森特共识》的实施。糖尿病中心的宣传与登记。

The Diabetic Foot Project of Flanders, the northern part of Belgium: implementation of the St Vincent consensus. Sensibilisation and registration in diabetes centres.

作者信息

Van Acker K, Weyler J, De Leeuw I

机构信息

Department of Endocrinology, Diabetic Foot Clinic, University Antwerp, University Hospital, Wilrijkstraat 10, B-2650 Edegem.

出版信息

Acta Clin Belg. 2001 Jan-Feb;56(1):21-31. doi: 10.1179/acb.2001.005.

Abstract

As a result of the St Vincent declaration, a Belgian "task force" was installed in 1992 and consequently 16 working groups were formed. They presented their objectives in 1995. The working group "prevention and treatment of diabetic foot lesions" started the implementation of a screening program to obtain an overview of the presentation of diabetic foot lesions, the amputation rate and the prevalence of patients with a foot at risk. This study reports the results from 43 out of 73 Flemish diabetes centres. 1653 patients were enrolled in this study (53% women, 47% men, median age 61). 34.6% were type 1 and, 65.4% type 2. One or more arterial pedal pulses were absent in 28%, 30.5% had an abnormal monofilament test, 35% skin lesions and 28% malformations. Still 19% smoked, 15.8% had visual problems and 11% had already developed an ulcer previously. Ulcers were reported in 8.7% of which almost 2/3 belonged to Wagner class I. 69 (3.87%) of the patients had had amputations. According to the four-risk categories-scale 46.3% of the patients belonged to the highest one; peripheral vascular disease, previous amputations, previous ulcers, and Charcot joints. In our region we didn't have previous data on the prevalence and morbidity of the amputation rate with diabetes patients. We observed 3.87% amputations, which is rather high in comparison with international data (0.44% - 2.4%). The general follow-up of diabetic foot problems can be organised in co-operation with other care providers. A national program therefore is going to start in the next months. We all have to be aware of the size of the problem to offer the best possible prevention. As we have seen, the use of inlay soles and podiatrist-made ortheses for example is very low. We hope that all care providers will participate in this important project, so that they will acquire a specific attitude towards these patients. In daily clinical practice there are some key-roles to be respected by all health care providers. In our opinion the next are of the utmost importance: take off your diabetic patient's shoes when they visit you; give specific education if your patient has a foot at risk; if an ulcer is present, carefully follow-up is mandatory and if no good evolution of the ulcer is seen, an early referral to a diabetic foot clinic is obvious. Together we can lower down the amputation rate of diabetic foot lesions. And that would be a marvelous implementation of the St Vincent declaration in Belgium.

摘要

由于《圣文森特宣言》,1992年成立了一个比利时“特别工作组”,随后组建了16个工作组。它们于1995年提出了目标。“糖尿病足病变的预防和治疗”工作组开始实施一项筛查计划,以全面了解糖尿病足病变的表现、截肢率以及足部有风险患者的患病率。本研究报告了73个佛兰德糖尿病中心中43个中心的结果。1653名患者参与了本研究(53%为女性,47%为男性,中位年龄61岁)。34.6%为1型糖尿病,65.4%为2型糖尿病。28%的患者一个或多个足背动脉搏动消失,30.5%的患者单丝试验异常,35%有皮肤病变,28%有畸形。仍有19%的患者吸烟,15.8%有视力问题,11%之前已经发生过溃疡。报告的溃疡发生率为8.7%,其中近2/3属于瓦格纳I级。69名(3.87%)患者进行了截肢。根据四风险类别量表,46.3%的患者属于最高风险类别;外周血管疾病、既往截肢、既往溃疡和夏科关节。在我们地区,之前没有关于糖尿病患者截肢率的患病率和发病率的数据。我们观察到截肢率为3.87%,与国际数据(0.44% - 2.4%)相比相当高。糖尿病足问题的总体随访可以与其他护理提供者合作进行。因此,一个全国性计划将在接下来的几个月启动。我们都必须意识到这个问题的规模,以便提供尽可能好的预防措施。正如我们所见,例如镶嵌鞋垫和足病医生制作的矫形器的使用非常少。我们希望所有护理提供者都能参与这个重要项目,以便他们对这些患者形成一种特定的态度。在日常临床实践中,所有医疗保健提供者都应尊重一些关键角色。我们认为以下几点至关重要:糖尿病患者就诊时帮他们脱掉鞋子;如果患者足部有风险,给予特定教育;如果存在溃疡,必须仔细随访,如果溃疡没有良好进展,显然应尽早转诊至糖尿病足诊所。我们共同努力可以降低糖尿病足病变的截肢率。这将是《圣文森特宣言》在比利时的一个了不起的落实。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验