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【medical-news】感染性糖尿病足不一定是截肢的手
Management of the septic foot is a challenge in diabetic patients, and this condition often progresses to amputation in an effort to alleviate otherwise incurable infection. We designed and followed a protocol for the management of the septic diabetic foot and, after 2 years (May 2004 through June 2006), we analyzed the data related to 31 septic feet of 139 patients. The treatment protocol consisted of blood glucose control, intravenous antibiotic therapy, controlling comorbidities, revascularization, ulcer drainage and irrigation, systematic debridement, dressing changes and wound care, and amputation if necessary. The outcomes of interest were amputation and limb salvage. The analyses showed that frequent drainage and debridement, along with revascularization when indicated and possible, resulted in 4 (12.9%) major (below-the-knee) amputations and 3 transmetatarsal amputations. Of the 7 amputations, 3 were associated with ischemia, 4 with neuropathy, and 1 with neuropathy and ischemia. In follow-up, 1 patient with a prior history of septic diabetic foot required major amputation. Based on these findings, it is concluded that the septic diabetic foot is not necessarily an indication for amputation, and aggressive management by means of metabolic and surgical care can lead to a favorable outcome. Level of Clinical Evidence: 2
The Journal of Foot and Ankle Surgery
Volume 47, Issue 5, September-October 2008, Pages 419-423 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Septic Diabetic Foot is Not Necessarily an Indication for Amputation
感染性糖尿病足不一定是截肢手术的指征
Management of the septic foot is a challenge in diabetic patients, and this condition often progresses to amputation in an effort to alleviate otherwise incurable infection. We designed and followed a protocol for the management of the septic diabetic foot and, after 2 years (May 2004 through June 2006), we analyzed the data related to 31 septic feet of 139 patients. The treatment protocol consisted of blood glucose control, intravenous antibiotic therapy, controlling comorbidities, revascularization, ulcer drainage and irrigation, systematic debridement, dressing changes and wound care, and amputation if necessary.
对于糖尿病患者处理其感染性糖尿病足是一个挑战，在竭力减轻感染而其不可治愈时则常常进展到需要截肢。我们设计并遵循一种处理糖尿病足的方案，两年后（2004年五月-2006年6月），我们分析了139例患者中与31例感染性糖尿病足有关的数据。该治疗放案由血糖控制、 静脉抗生素治疗、控制并存病，血运重建，溃疡引流和冲洗，系统性清创，敷料更换和创口护理，如果必要时则截肢。
The outcomes of interest were amputation and limb salvage. The analyses showed that frequent drainage and debridement, along with revascularization when indicated and possible, resulted in 4 (12.9%) major (below-the-knee) amputations and 3 transmetatarsal amputations. Of the 7 amputations, 3 were associated with ischemia, 4 with neuropathy, and 1 with neuropathy and ischemia. In follow-up, 1 patient with a prior history of septic diabetic foot required major amputation.
其影响结果为截肢和保肢。分析显示在给与经常的引流和清创，当有指征并可能的情况下行血运重建治疗后，结果有4例(12.9%)大截肢（膝下）和3例经跖骨截肢。在所有7例截肢患者中，3例与缺血有关，4例与神经病变有关，1例有神经病变和缺血。随访发现仅1例有感染性糖尿病足病史的患者需要大截肢术。
Based on these findings, it is concluded that the septic diabetic foot is not necessarily an indication for amputation, and aggressive management by means of metabolic and surgical care can lead to a favorable outcome. Level of Clinical Evidence: 2
基于这些发现，我们的结论认为感染性糖尿病足不一定是截肢的指征，并且通过代谢和外科护理的方式积极地处理可能导致良好的结果。临床证据水平：2级
The Journal of Foot and Ankle Surgery
足踝外科杂志
Volume 47, Issue 5, September-October 2008, Pages 419-423
感染性糖尿病足不一定是截肢手术的指征
对于糖尿病患者处理其感染性糖尿病足是一个挑战，在竭力减轻感染而其不可治愈时则常常进展到需要截肢。我们设计并遵循一种处理糖尿病足的方案，两年后（2004年五月-2006年6月），我们分析了139例患者中与31例感染性糖尿病足有关的数据。该治疗放案由血糖控制、 静脉抗生素治疗、控制并存病，血运重建，溃疡引流和冲洗，系统性清创，敷料更换和创口护理，如果必要时则截肢。其影响结果为截肢和保肢。分析显示在给与经常的引流和清创，当有指征并可能的情况下行血运重建治疗后，结果有4例(12.9%)大截肢（膝下）和3例经跖骨截肢。在所有7例截肢患者中，3例与缺血有关，4例与神经病变有关，1例有神经病变和缺血。随访发现仅1例有感染性糖尿病足病史的患者需要大截肢术。基于这些发现，我们的结论认为感染性糖尿病足不一定是截肢的指征，并且通过代谢和外科护理的方式积极地处理可能导致良好的结果。临床证据水平：2级
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作者:admin@医学,生命科学 2010-10-02 17:11
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