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岭南现代临床外科 ›› 2019, Vol. 19 ›› Issue (02): 182-186.DOI: 10.3969/j.issn.1009-976X.2019.02.012

• 论著与临床研究 • 上一篇    下一篇

肇庆市怀集县人民医院糖尿病足患者的预后及影响因素分析

雷国大1, 陈丽燕2, 李莉3, 莫石柯1, 李永洁4, 杨川4*   

  1. 1.怀集县人民医院内一科,广东肇庆 526400;2. 中山大学护理学院,广州 510080;3.中山大学孙逸仙纪念医院急诊科,广州 510289;4.中山大学孙逸仙纪念医院内分泌科,广州 510120
  • 通讯作者: 杨川

Prognosis and influencing factors of diabetic foot patients in Huaiji People??s Hospital of Zhaoqing City

LEI Guoda1, CHEN Liyan2, LI Li3, MO Shike1, LI Yongjie4, YANG Chuan4   

  1. 1. Department of Internal Medicine, Huaiji People??s Hospital, Zhaoqing, 526400, China; 2. School of Nursing, Sun Yat?sen University, Guangzhou, 510030, China; 3. Em?ergency Department,Sun Yat?Sen Memorial Hospital of Sun Yat?sen University,G?uangzhou,510220, China; 4. Endocrine Department, Sun Yat?Sen Memorial Hospital of Sun Yat?sen University, Guangzhou, 510220, China
  • Online:2019-04-20 Published:2019-04-20
  • Contact: YANG Chuan

摘要: [摘要] 目的 了解怀集县人民医院糖尿病足患者的预后情况,并探讨其影响因素,为基层医院针对性干预提供参考。方法 采用整群抽样方法,选取怀集县人民医院住院糖尿病足患者154例,收集患者的相关病例资料和随访资料,回顾性分析农村糖尿病足患者出院后愈合、死亡情况及影响因素。结果 154例糖尿病足患者中愈合121例,愈合率为78.6%;1年、3年、5年累计死亡率分别为9.1%、11.0%、11.7%,低蛋白血症(OR=3.467)、高密度脂蛋白(OR=3.478)、溃疡数目(OR=5.182)是影响农村糖尿病足患者溃疡愈合的独立危险因素(均P<0.05);高密度脂蛋白(RR=0.246)、糖尿病肾病(RR=0.209)、溃疡数目(RR=0.226)是影响糖尿病足患者死亡的独立预测因素,其中高密度脂蛋白是保护因素(均P<0.05)。结论 对于基层医院糖尿病足患者,预后由多种因素综合作用,其中低蛋白血症、糖尿病肾病、溃疡数目非单发和高密度脂蛋白均显著影响患者预后,应给予针对性的干预措施,促进足溃疡愈合,延长生存时间。

关键词: 糖尿病足, 预后, 农村

Abstract: [Abstract] Objective To describe the situation of the prognosis and analyze the risk factors of diabetic foot patients in Huaiji People??s Hospital in order to provide reference for target intervention in grass?roots hospitals. Methods By cluster sampling, 154 inpatients with diabetic foot in Huaiji People??s Hospital were selected. Relevant cases and follow?up data were collected. The healing, mortality and influencing factors of rural patients with diabetic foot after discharge were analyzed retrospectively. Results Among 154 cases of diabetic foot, 121 cases healed, the healing rate was 78.6%. The cumulative mortality rates of 1,3 and 5 years were 9.1%, 11.0% and 11.7%, respectively. Hypoproteinemia (OR=3.467), high density lipoprotein (OR=3.478), number of ulcers (OR=5.182) were independent risk factors affecting the healing of ulcers in rural diabetic foot patients (P<0.05); high density lipoprotein (RR=0.246), glycosuria. Disease nephropathy (RR=0.209) and number of ulcers (RR=0.226) were independent predictors of death in patients with diabetic foot, and high density lipoprotein was a protective factor(P<0.05). Conclusion For patients with diabetic foot in grass?roots hospitals, the prognosis is affected by many factors, including hypoproteinemia, diabetic nephropathy, non?single ulcer number and high density lipoprotein. Targeted interventions should be given to promote the healing of foot ulcer and prolong survival time.

Key words: diabetic foot, prognosis, rural area

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