摘要
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。
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.
出处
《中国骨伤》
CAS
2006年第6期333-334,共2页
China Journal of Orthopaedics and Traumatology
