糖尿病足综合征患者紧急外科援助的现状

V. I. Lyakhovsky, O. H. Krasnov, R.B. Lisenko, T. V. Gorodova-Andreeva, Oleksandr M. Liulka, N. O. Lyakhova, O. Krasnova
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引用次数: 0

摘要

目的:提高糖尿病足综合征患者的急诊外科护理水平。材料与方法:对268例糖尿病足综合征(DFS)患者进行治疗。第一组(136例)选取2012-2016年住院的患者,按照临床开发的方法进行器官保留手术(126例)。第二组(132例)由2017-2021年入院的患者组成。结果:主组以DFS的形式决定手术治疗。有神经病变形式:I期手术治疗病灶,II期塑料缝合伤口。神经缺血型(60例):I期-缺血矫正;II期:手术治疗病灶;第三阶段:用塑料缝合伤口。主组10例(7.3%)患者在胫、大腿水平行截肢。在对照组,19例(14.4%)患者在大腿水平行截肢。结论:应根据DFS的形态,确定组织活力,对DFS进行器官保留治疗。在影响愈合速度的因素中,伤口的形状、大小和定位是重要的。
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CURRENT ASPECTS OF URGENT SURGICAL ASSISTANCE IN PATIENTS WITH DIABETIC FOOT SYNDROME
Aim: Improving emergency surgical care for patients with diabetic foot syndrome. Materials and methods: We conducted treatment of 268 patients with diabetic foot syndrome (DFS). The first group (136 patients) consisted of patients admitted to the hospital in 2012-2016, organ-preserving operations were performed according to the methods developed in the clinic (126 patients).The second group (132 patients) consisted of patients admitted in 2017-2021. Results: In the main group, surgical treatment was determined by the form of DFS. There were in the neuropathic form: stage I – surgical treatment of the focus, and stage II – plastic closure of the wound. There were in neuroischemic form (60 patients): stage I – correction of ischemia; stage II – surgical treat¬ment of the focus; stage III – plastic closure of the wound. In 10 (7.3%) patients of the main group amputations were performed at the level of the shin and the thigh. In the control group, in 19 (14.4%) patients, amputation was performed at the level of the thigh. Conclusions: Organ-preserving treatment of DFS should be carried out in accordance with the form of DFS with determination of tissue viability. Among the factors influencing the rate of healing, the shape of the wound, its size and localization are important.
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