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題名 | Hyperbaric Oxygen in the Treatment of Diabetic Foot Infection=高壓氧在治療糖尿病足之臨床地位 |
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作者 | 李炫昇; 陳昭宇; 詹益聖; 顏政佑; 趙恩塏; 翁文能; | 書刊名 | 長庚醫學 |
卷期 | 20:1 1997.03[民86.03] |
頁次 | 頁17-22 |
分類號 | 415.668 |
關鍵詞 | 糖尿病足; 高壓氧治療; Diabetic foot; Hyperbaric oxygen; |
語文 | 英文(English) |
中文摘要 | 背景:雖然高壓氧治療已列入全民健保之給付範圍,但是其臨床應用仍未被廣泛接受。本研究的目的是分析糖尿病足部感染之多重癒合預測因子,以探討高壓氧治療在治療是類病患之地位。 方法:從1995年3月至1996年5月,共有31位糖尿病足部感染之病患接受包括良好血糖控制、傷口清創、及輔助性高壓氧治療。病患資料、實驗室檢查結果包括白血球數、淋巴球總數、血紅素、紅血球沉降速率、C-反應蛋白(CRP)、糖化血紅素(HbAlc)、白蛋白、足-肘血壓比(Ankle-Brachial Index)、細菌培養結果、以及手術次數均加以詳細紀錄。 結果:所有的病人平均年齡為63歲,平均接受35.3次高壓氧治療,在31位病人中有25位成功保留足部或得到更低位之截肢,有6位則接受膝下截肢。利用多重迴歸分析及卡方檢定, 發現高白血球數和低足-肘血壓比(Ankle-Brachial Index)與治療結果失敗有關(p<0.05)。 結論:作者們認為在治療糖尿病足部感染,若足部仍有足夠之血循、感染能被控制的話,輔助性高壓氧治療將是助長傷口癒合之利器。 |
英文摘要 | BACKGROUND: Although hyperbaric oxygen therapy to treat diabetic foot lesions has been approved for insurance reimbursement in Taiwan, its clinical application has not yet been well accepted. This study evaluated multiple healin g predictive factors in patients with diabetic foot infections to determine the usefulness of adjunctive hyperbaric oxygen in the treatment of such patients. METHODS: From March 1995 to May 1996, we treated 31 diabetic patients presenting with infected foot lesions with a regimen of adequate metabolic control, frequent wound debridement and hyperbaric oxygen therapy. Age, gender, leukocyte count, total lymphocyte count, hemoglobin, erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), glycosylated hemoglobin A1c (HbAlc), albumin, ankle-brachial index, types of bacterial cultures and number of debridements were compared between successful and failed treatments. Independent t-test and Fisher's exact test were used to identify the prognostic factors associated with outcome of treatment. RESULTS: The mean age of the patients was 63.0 ± 9.7 years (range 43 to 81). Of The mean numer of hyperbaric oxygen therapies was 35.3 ± 21.8 treatments the range 5 to 83). Of the 31 patients, 6 received below knee amputation, and 25 had their foot preserved or achieved a lower level of amputation. Elevated leukocyte count and low ankle-branchial index were significantly related to poor outcome. CONCLUSIONS: In the treatment of diabetic foot infection, adjunctive hyperbaric oxygen therapy seems to be a useful tool to enhance wound healing provided that there are preserved circulation and controlled infection. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。