通过糖尿病教育预防截肢

Prevention of amputation by diabetic education.

作者信息

Malone J M, Snyder M, Anderson G, Bernhard V M, Holloway G A, Bunt T J

机构信息

Department of Surgery, Maricopa Medical Center, Tucson Veterans Administration Medical Center, Arizona.

出版信息

Am J Surg. 1989 Dec;158(6):520-3; discussion 523-4. doi: 10.1016/0002-9610(89)90183-9.

DOI:10.1016/0002-9610(89)90183-9

PMID:2589581

Abstract

This prospective randomized study evaluated the influence of a simple education program on the incidence of lower extremity amputation in diabetic patients. Two hundred three patients were randomized into two groups: Group 1, education (103 patients, 203 limbs) and Group 2, no education (100 patients, 193 limbs). There were no significant differences in medical management or clinical risk factors between the two groups. The amputation rate was three times higher in Group 2 (21 of 177 limbs versus 7 of 177 limbs; p less than or equal to 0.025), the ulceration rate was three times higher in Group 2 (26 of 177 limbs versus 8 of 177 limbs; p less than or equal to 0.005), and there was no difference in the overall incidence of infection (2 of 177 limbs). Overall success in Group 1 was highly significantly different from Group 2 (160 of 177 limbs versus 128 of 177 limbs; p less than or equal to 0.0005). This study demonstrated that a simple education program significantly reduced the incidence of ulcer or foot and limb amputation in diabetic patients.

摘要

这项前瞻性随机研究评估了一个简单的教育项目对糖尿病患者下肢截肢发生率的影响。203名患者被随机分为两组：第1组为接受教育组（103名患者，203条肢体），第2组为未接受教育组（100名患者，193条肢体）。两组在医疗管理或临床危险因素方面无显著差异。第2组的截肢率高出三倍（177条肢体中有21条截肢，而177条肢体中有7条截肢；p≤0.025），第2组的溃疡率高出三倍（177条肢体中有26条发生溃疡，而177条肢体中有8条发生溃疡；p≤0.005），感染总发生率无差异（177条肢体中有2条感染）。第1组的总体成功率与第2组有极显著差异（177条肢体中有160条成功，而177条肢体中有128条成功；p≤0.0005）。这项研究表明，一个简单的教育项目能显著降低糖尿病患者溃疡或足部及肢体截肢的发生率。