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目的:通过对组内近10年来糖尿病病例的回顾,总结糖尿病皮肤慢性溃疡的流行病学特征,并分析影响治疗效果的相关影响因素。 方法:对1991/2000两所医院的11 369例糖尿病患者一般资料进行回顾性统计,并对其中234例糖尿病皮肤慢性溃疡病例的不同治疗方法进行比较。 结果:11 369例糖尿病患者234例发生慢性皮肤溃疡,发病率2.058％,均为2型糖尿病患者。糖尿病皮肤慢性溃疡好发部位依次为:下肢,骶 尾部及其他部位。234例患者中,非手术50例,48例痊愈,愈合时间52～84 d。手术184例,180例痊愈,愈合时间21～30 d。血管超声检查显示糖尿病足患者皆有动脉壁(股总动脉、股浅动脉、国动脉胫后动脉、足背动脉)增厚,内膜粗遭,管腔不规则狭窄,血流阻力数较高。结论:糖尿病皮肤慢性溃疡的治疗应是综合性的。控制血糖水平、改善局部血液、准备创面床、手术植皮是治疗糖尿病皮肤慢性溃疡的有效方法。
OBJECTIVE: To review the epidemiological characteristics of chronic skin ulcers in diabetic patients by reviewing the cases of diabetes mellitus in the past 10 years and to analyze the influencing factors influencing the therapeutic effect. Methods: The retrospective statistics of 11 369 diabetics in two hospitals in 1991/2000 were retrospectively analyzed, and 234 different cases of diabetic patients with chronic skin ulcers were compared. Results: A total of 234 cases of 11369 diabetic patients developed chronic skin ulcer with the incidence of 2.058%, all of whom were type 2 diabetic patients. Diabetic skin chronic ulcer prone areas are: lower extremities, sacrococcygeal and other parts. Of the 234 patients, 50 were nonoperating and 48 were cured with a healing time of 52-84 days. 184 cases of surgery, 180 cases healed, healing time 21 ~ 30 d. Vascular ultrasonography showed that all patients with diabetic foot had thickening of the arterial wall (femoral artery, superficial femoral artery, posterior tibial artery, dorsalis pedis artery), thick endometrium, irregular luminal stenosis and high blood flow resistance . Conclusion: The treatment of diabetic chronic skin ulcers should be comprehensive. Control of blood glucose levels, improve local blood, prepare wound bed, skin graft surgery is an effective method of treatment of chronic skin ulcers in diabetic patients.