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目的:通过对36例糖尿病足截肢患者的分析,探讨糖尿病足截肢适应症及截肢平面的选择方法。方法:本研究分两个层面进行展开,首先拟通过截肢组、溃疡组、非溃非截组的比较研究探求与截肢关系最为密切的症状、体征及辅助检查;其次重点对36例截肢患者资料进行全面分析。最后参照二者所得结论,归纳总结出截肢的适应证及截肢平面选取标准。结果:3组中截肢组足部病变出现时间最短,溃疡组其次,非溃非截组较长,且3组间相互比较具有显著性差异(P<0.05)。Apo-b及FIB截肢组与其他两组相比较均具有显著性差异,而Apo-a1截肢组与溃疡组比较具有显著性差异。结论:积分小于19分者不需截肢,19～25分之间者可截可不截,大于25分者需截肢治疗。积分越高则截肢的风险相应亦高。APO-a1、APO-b、FIB是表示伤者全身状况的参数,全身状况差使一些“临界性”伤肢值增高,促使截肢成为必然。
OBJECTIVE: To investigate the indications of amputation of diabetic foot and the selection of amputation plane by analyzing 36 cases of diabetic foot amputation. Methods: This study was carried out in two levels. First of all, we should explore the most relevant symptoms, signs and auxiliary examinations by amputation group, ulcer group and non-ulcer non-truncated group. Secondly, we focus on 36 cases of amputation patients Conduct a comprehensive analysis. Finally, with reference to the conclusion of the two, summarize the indications of amputation and amputation plane selection criteria. Results: In the three groups, the shortest pathological changes occurred in the amputation group, followed by the ulcer group, followed by the non-ulcer and non-truncated group, and there was significant difference between the three groups (P <0.05). Apo-b and FIB amputation group compared with the other two groups were significantly different, while Apo-a1 amputation group and ulcer group was significantly different. Conclusion: The score less than 19 points without amputation, 19-25 points can be truncated, more than 25 points required amputation. The higher the point, the higher the risk of amputation. APO-a1, APO-b and FIB are parameters that indicate the general condition of the injured. Poor general condition makes some “critical” injured limbs higher, making amputation inevitable.