362例糖尿病足感染患者的临床特点调查分析

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摘要目的调查分析糖尿病足感染(diabetic foot infection，DFI)患者的临床特点，为临床有效防控DFI提供参考依据。方法回顾性分析恩施州中心医院2018年1月至2020年12月收治住院的362例DFI患者的病例资料，按糖尿病足Wagner分级标准将研究对象分为轻型DFI组和重型DFI组，其中轻型DFI组150例(41.44%)，重型DFI组212例(58.56%)，男性245例(67.68％)，女性117例(32.32％)，初中以下文化程度286例(79.01%)。统计患者基本信息，创面微生物培养结果及生化结果，治疗方式和结果以及卫生经济学信息，分别比较两组临床特点。结果两组患者性别、身体质量指数(body mass index，BMI)及周围血管病变比较，差异具有统计学意义(P＜0.05)。糖尿病足感染发生部位以足趾多见，345例DFI患者(95.31%)共培养出524株病原菌，以金黄色葡萄球菌(23.28%)、铜绿假单胞菌(15.65%)和肺炎克雷伯菌(11.45%)为主。重型DFI组混合病原菌感染率和革兰阴性菌感染率均高于轻型DFI组(P＝0.032，P＝0.015)。与轻型DFI组相比，重型DFI组患者白细胞计数(white blood cell counts，WBC)、中性粒细胞百分比(neutrophils percentage，NEUT)、降钙素原(procalcitonin，PCT)和C反应蛋白(C-reactive protein，CRP)水平均升高，差异均具有统计学意义(P＜0.05)。248例(68.51%)患者采取手术治疗，重型DFI组与轻型DFI组痊愈情况及截肢/趾比较，差异具有统计学意义(P＜0.05)。DFI患者平均住院时间24 d，平均住院费用34 250元。重型DFI组与轻型DFI组住院时间及平均费用比较，差异有统计学意义(P＜0.05)。结论笔者单位收治DFI患者以重型DFI患者居多，男性为主，并发症多，感染率及截肢/趾率高，对社会及患者家庭造成了极大的经济负担，尚需加强DFI创面预防及健康宣教。

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	温丰平
	刘行
	田世坤

关键词 ：糖尿病足, 感染, 临床特点

Abstract：Objectie To investigate and analyze the clinical characteristics of inpatients with diabetic foot infection (DFI) and provide reference for effective clinical prevention and treatment of DFI.Methods The medical records of patients with diabetic foot infection who were admitted to the central hospital of enshi prefecture from January 2018 to December 2020，were retrospectively analyzed.According to Wagner classification，the DFI patients were divided into mild DFI group(41.44%) and severe DFI group(58.56%).Among the patients there were 245 males(67.68％) and 117 females(32.32％).Primary school and junior high school accounted for the highest proportion of education level (79.01%).Characteristics including patients basic data，wound microbiology information，therapies，outcomes，and health economics information were analyzed and compared between the two groups.Results There were statistically significant difference in gender distribution、BMI and peripheral vascular disease of patients of different groups(P＜0.05).Diabetic foot infections were more common in the toes.There were 524 strains of microorganisms isolated from the 345 patients (95.31%)，including Staphylococcus aureus (23.28%)，Pseudomonas aeruginosa (15.65%)，and Klebsiella pneumoniae (11.45%).The severe DFI group had significantly higher ratios of polymicrobial bacteria and Gram-negative bacteria infections(P＝0.032，P＝0.015)，and increased levels of white blood cell counts(WBC)，neutrophils percentage (NEUT)，procalcitonin (PCT)，and C-reactive protein (CRP)(all P＜0.05) when compared with the mild DFI group.248(68.51%)patients were treated by surgery.There were significant differences in ratios of recovery and amputation between severe DFI group and mild DFI group(P＜0.05).The average hospitalization time of patients with DFI was 24 days with the average hospitalization cost of 34 250 yuan.There were statistically significant differences in the hospitalization time and hospitalization cost between severe DFI group and mild DFI group(P＜0.05).Conclusion There are more male patients with DFI in the author’s unit.The high rate of complications，infection and amputation bring serious economic burden to the patients and the society.It is necessary to strengthen the prevention and health education of DFI.

Key words： Diabetic foot Infection Clinical characteristics

基金资助:恩施州科技计划研究与开发项目(JCY2019000011)

作者简介: 温丰平(1985－ )，男，主治医师，恩施土家族苗族自治州中心医院关节外科，ww122900@126.com。

引用本文:

温丰平，刘行，田世坤. 362例糖尿病足感染患者的临床特点调查分析[J]. 实用骨科杂志, 2022, 28(1): 25-29.
Wen Fengping，Liu Xing，Tian Shikun. Investigation and Analysis on Clinical Characteristics of 362 Inpatients with Diabetic Foot Infection. sygkzz, 2022, 28(1): 25-29.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2022/V28/I1/25

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