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[糖尿病相关足部问题]

[Diabetes-related foot problems].

出版信息

Duodecim. 2009;125(17):1907-9.

Abstract

Foot ulcers due to neuropathy and/or ischemia, often complicated by infection, are a leading cause of hospitalisation and amputation in diabetic patients. Sensory neuropathy, foot abnormality, missing pulses and previous history of ulcers or amputation are risk factors for ulceration. Regular examination of feet and protective footwear reduce this risk. Off-loading the ulcer area promotes healing. Revascularisation improves the blood supply in cases where it has been compromised. Systemic antibiotics are only required in the case of acute foot infections and osteomyelitis with an underlying ulcer. Prevention and treatment of foot ulceration by multidisciplinary teams, including podiatric services, decreases amputations by up to 85%.

摘要

由神经病变和/或局部缺血引起的足部溃疡,常并发感染,是糖尿病患者住院和截肢的主要原因。感觉神经病变、足部畸形、脉搏消失以及既往溃疡或截肢史是溃疡形成的危险因素。定期检查足部和穿着防护鞋可降低这种风险。减轻溃疡部位的压力有助于愈合。在血供受损的情况下,血管重建可改善血液供应。仅在急性足部感染和伴有潜在溃疡的骨髓炎病例中需要使用全身性抗生素。由包括足病服务在内的多学科团队进行足部溃疡的预防和治疗,可将截肢率降低多达85%。

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