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多学科团队模式下住院糖尿病足患者的治疗结果:泰国的经验

Outcomes of hospitalized diabetic foot patients in a multi-disciplinary team setting: Thailand's experience.

作者信息

Thewjitcharoen Yotsapon, Krittiyawong Sirinate, Porramatikul Sriurai, Parksook Wyn, Chatapat Lapakorn, Watchareejirachot Orawan, Sripatpong Jeeraphan, Himathongkam Thep

机构信息

Diabetes and Thyroid Center, Theptarin Hospital, 3858 Rama IV Rd, Klong Toey, Bangkok 10110, Thailand.

出版信息

J Clin Transl Endocrinol. 2014 Oct 15;1(4):187-191. doi: 10.1016/j.jcte.2014.10.002. eCollection 2014 Dec.

Abstract

AIMS

The aims of this study were to evaluate the outcomes of treatment among hospitalized patients with diabetic foot ulcers, the risk factors for non-healing ulcers, and the rate of major amputation among Thai patients.

METHODS

A retrospective study of hospitalized diabetic foot patients treated at Theptarin Hospital during the period of 2009-2013. The complete healing rate was assessed at 12 months after admission.

RESULTS

During the study period, 232 patients (123 males and 109 females) with 262 admissions were included (mean age 65.6 ± 11.9 years, mean duration of diabetes 17.2 ± 9.9 years) with a mean follow-up of 17.5 ± 16.7 months. Major amputations were performed in 4.2% of the patients and peripheral vascular disease (PVD) was a predictive factor (OR 5.25; 95% CI [1.43-19.29]; -value 0.006). Complete healing (including minor amputations) was achieved in 82.1% of the admissions. Only DFU of the heel was a statistically significant (OR 3.34; 95% CI [1.11-10.24]; -value 0.041) predictor of non-healing ulcers. Three patients (1.1%) died during hospitalization.

CONCLUSIONS

Management of diabetes-related foot ulcers with a multidisciplinary approach resulted in a limb salvage rate that was greater than 90% and a complete healing rate that was greater than 80%. Successful management of diabetic foot ulcers might be possible in Thailand utilizing this approach.

摘要

目的

本研究旨在评估泰国住院糖尿病足溃疡患者的治疗结果、溃疡不愈合的危险因素以及大截肢率。

方法

对2009年至2013年期间在泰帕林医院接受治疗的住院糖尿病足患者进行回顾性研究。在入院12个月后评估完全愈合率。

结果

在研究期间,纳入了232例患者(123例男性和109例女性),共入院262次(平均年龄65.6±11.9岁,平均糖尿病病程17.2±9.9年),平均随访时间为17.5±16.7个月。4.2%的患者接受了大截肢手术,外周血管疾病(PVD)是一个预测因素(比值比5.25;95%置信区间[1.43 - 19.29];P值0.006)。82.1%的入院患者实现了完全愈合(包括小截肢)。仅足跟部的糖尿病足溃疡是溃疡不愈合的统计学显著预测因素(比值比3.34;95%置信区间[1.11 - 10.24];P值0.041)。3例患者(1.1%)在住院期间死亡。

结论

采用多学科方法管理糖尿病相关足溃疡,保肢率大于90%,完全愈合率大于80%。在泰国采用这种方法可能成功管理糖尿病足溃疡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b46/5685051/37fbb14da73d/gr1.jpg

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