Spanos Konstantinos, Saleptsis Vasileios, Athanasoulas Athanasios, Karathanos Christos, Bargiota Alexandra, Chan Philip, Giannoukas Athanasios D
1 Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
2 Department of Endocrinology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Angiology. 2017 Mar;68(3):242-250. doi: 10.1177/0003319716651166. Epub 2016 Jul 11.
A prospective nonrandomized cohort study on consecutive diabetic patients with foot ulcer was undertaken to assess the factors associated with the healing process or limb salvage and evaluate the impact of their treatment on their quality of life. Quality of life was evaluated using Diabetic Foot Ulcer Scale-Short Form (DFS-SF) questionnaire before and after treatment. A total of 103 diabetic patients with ulcer (mean age 69.7 ± 9.6 years, 77% male) were treated and followed up for 12 months. Ulcer healing, minor amputation, and major amputation rates were 41%, 41%, and 18%, respectively, while the mortality rate was 18%. Ulcer healing was associated with University of Texas wound grade 1 and the Study of Infections in Diabetic feet comparing Efficacy, Safety and Tolerability of Ertapenem versus Piperacillin/Tazobactam trial's diabetic foot infection wound score. Limb loss was associated with nonpalpable popliteal artery, longer in-hospital stay, and delay until referral. Quality of life was improved in all domains of DFS-SF ( P < .0001) throughout the cohort of our patients regardless of their outcome, and no outcome (healing, minor amputation, or major amputation) was superior to other. Significant improvement was observed in all domains of hygiene self-management after consultation during the follow-up period.
我们开展了一项针对连续性糖尿病足溃疡患者的前瞻性非随机队列研究，以评估与愈合过程或肢体保全相关的因素，并评估治疗对患者生活质量的影响。在治疗前后，使用糖尿病足溃疡简明量表（DFS-SF）问卷对生活质量进行评估。共有103例糖尿病溃疡患者（平均年龄69.7±9.6岁，77%为男性）接受治疗并随访12个月。溃疡愈合率、小截肢率和大截肢率分别为41%、41%和18%，死亡率为18%。溃疡愈合与德克萨斯大学伤口分级1级以及糖尿病足部感染疗效、安全性和耐受性比较研究（厄他培南与哌拉西林/他唑巴坦对比试验）的糖尿病足感染伤口评分相关。肢体缺失与腘动脉无法触及、住院时间延长以及转诊延迟相关。在我们所有患者中，无论结果如何，DFS-SF所有领域的生活质量均得到改善（P<0.0001），且没有哪种结果（愈合、小截肢或大截肢）优于其他结果。在随访期间咨询后，卫生自我管理的所有领域均观察到显著改善。
