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老年重症糖尿病足坏疽截肢的围手术期治疗分析
Hits: 2333   Download times: 1607   Received:November 15, 2005    
作者Author单位UnitE-Mail
陈亚冠 CHEN Ya-guan 上海市中西医结合医院骨科,上海200082 Department of Orthopaedics,Shanghai Traditional Chinese and Western Medicine Integrated Hospital,Shanghai 200082,China yaguan.chen@gmailcom 
曹烨民 CAO Ye-min 上海市中西医结合医院脉管病研究所  
陈强 CHEN Qiang 上海市中西医结合医院骨科,上海200082 Department of Orthopaedics,Shanghai Traditional Chinese and Western Medicine Integrated Hospital,Shanghai 200082,China  
张建明 ZHANG Jian-ming 上海市中西医结合医院骨科,上海200082 Department of Orthopaedics,Shanghai Traditional Chinese and Western Medicine Integrated Hospital,Shanghai 200082,China  
郑璐 ZHENG Lu 上海市中西医结合医院骨科,上海200082 Department of Orthopaedics,Shanghai Traditional Chinese and Western Medicine Integrated Hospital,Shanghai 200082,China  
期刊信息:《中国骨伤》2006年19卷,第6期,第333-334页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:探讨老年重症糖尿病足坏疽截肢的围手术期治疗方法。

方法:自2002年6月-2005年6月手术治疗糖尿病足坏疽截肢48例,男28例,女20例;年龄60~84岁,平均73岁。46例单侧下肢截肢,2例双侧下肢截肢。膝上截肢29肢,膝下截肢18肢,半足截肢3足。按Waganer分类:Ⅳ级26例,Ⅴ级22例。

结果:48例中愈合46例,死亡2例。其中甲级愈合44例,甲级愈合率88%。心肌梗死1例,脑梗死1例。术后残端坏死2例,创面感染2例。

结论:老年重症糖尿病足坏疽截肢存在高危险性,良好的围手术期处理和准确判断截肢平面是手术成功的关键。
[关键词]:糖尿病足  截肢术  老年人
 
Perioperative management of amputation for the serious gangrene of diabetic foot in senile patients
Abstract:

Objective:To discuss the perioperative management of amputation for the serious gangrene of foot in senile diabetic patients.

Methods:From 2002.6 to 2005.6,48 patients with serious gangrene of diabetic foot were treated with amputation.Among them,28 patients were male and 20 patients were female,ranging in age from 60 to 84 years(mean 73 years).According to Waganer’s classification,26 patients were Type Ⅳ and 22 patients were Type Ⅴ(two patients had both legs amputation).Single side amputation were performed in 46 patients and double side amputation performed in 2 patients.Twenty-nine legs were amputated above knee, 18 legs were amputated below knee,and 3 feet were semi-foot amputation.

Results:Among 48 patients,46 patients had incision healing and 2 patients were dead.Forty-four patients healed to the first degree,and the healing rate was 88%.Myocardial infarction occurred in one patient and cerebral infarction occurred in one patient.Two patients had stump necrosis after operation and 2 patients had wound infection.

Conclusion:The amputation for the treatment of serious diabetic foot in senile patients is of highly dangerous.Good perioperative management and accurate judgement of amputation level are the key to obtain excellent therapeutic effects.
KEYWORDS:Diabetic foot  Osteotomy  Aged
 
引用本文,请按以下格式著录参考文献:
中文格式:陈亚冠,曹烨民,陈强,张建明,郑璐.老年重症糖尿病足坏疽截肢的围手术期治疗分析[J].中国骨伤,2006,19(6):333~334
英文格式:CHEN Ya-guan,CAO Ye-min,CHEN Qiang,ZHANG Jian-ming,ZHENG Lu.Perioperative management of amputation for the serious gangrene of diabetic foot in senile patients[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(6):333~334
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