尼日利亚伊洛林大学教学医院糖尿病患者足部溃疡风险评估

J. Olarinoye, A. Bello, Saint Ogunkeyede, A. Aderibigbe, B. Olagbaye, K. Wahab
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摘要

背景:糖尿病足溃疡的并发症常常严重威胁糖尿病患者的生命。本研究的目的是评估在尼日利亚伊洛林伊洛林大学教学医院就诊的糖尿病患者足部溃疡的危险因素。材料与方法:对151例糖尿病患者进行问卷调查,了解他们的社会人口学、足部护理和糖尿病相关细节。然后对他们的双脚进行皮肤变化、肌肉骨骼畸形、神经和血管并发症的评估。根据国际糖尿病足工作组的糖尿病足风险分类系统进行风险分层。数据分析采用SPSS version 22。分类变量的比较采用卡方检验,危险类别与患者特征的相关性采用Pearson相关系数,P < 0.05为有统计学意义。结果与结论:间歇性跛行40例(26.5%),感觉异常76例(50.3%)。89人(58.9%)接受过足部护理教育,仅有7人(4.6%)有糖尿病足部特殊磨损。右脚27例(17.9%),左脚23例(15.2%)单丝敏感性受损。右侧病变36例(23.9%),左侧病变30例(19.9%)。糖尿病病程越长,患病风险越高(P = 0.04)。未接受过教育的患者发生糖尿病足溃疡(DFU)的风险显著增高(P = 0.01)。离退休人员患病风险较高(P = 0.01)。此外,肾脏疾病(P = 0.046)、心血管疾病(P = 0.001)和视力障碍(P = 0.19)的存在都是我们研究人群中发生DFU的高风险因素。总体评估显示,本研究中“足部风险”的患病率为30.5%,我们认为这足以引起更严重的关注。
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Risk assessment for foot ulceration in a nigerian diabetic population attending university of Ilorin teaching hospital, Ilorin
Background: Complications from diabetic foot ulcer often pose a strong threat to the life of patients with diabetes. The aim of this study was to evaluate the risk factors for foot ulceration among people living with diabetes attending University of Ilorin Teaching Hospital, Ilorin, Nigeria. Materials and Methods: One hundred and fifty-one diabetic patients were interviewed with a questionnaire to obtain their sociodemographic, foot care, and diabetes-related details. Both of their feet were then assessed for dermatological changes, musculoskeletal deformities, neurological and vascular complications. Risk stratification was done according to the diabetic foot risk classification system of the International Working Group on Diabetic Foot. Data were analyzed using SPSS version 22. Categorical variables were compared using the Chi-square test while correlation between the risk categories and patients' characteristics was determined using Pearson's Correlation Coefficient, setting statistical significance at P < 0.05. Results and Conclusion: Intermittent claudication was found in 40 patients (26.5%), 76 (50.3) had paresthesia. Eighty nine (58.9%) had foot care education but only 7 (4.6%) had special diabetic foot wears. Impaired monofilament sensitivity was seen in 27 (17.9%) of the right feet and in 23 (15.2%) of the left feet. Significant peripheral neuropathy was detected in 36 (23.9%) on the right and 30 (19.9%) on the left side. It was found that the longer the duration of diabetes, the higher the risk (P = 0.04). Furthermore, patients who had no education had significantly higher risk for diabetes foot ulcer (DFU) (P = 0.01). High risk was discovered among the retirees (P = 0.01). In addition, presence of kidney disease (P = 0.046), cardiovascular disease (P = 0.001), and visual impairment (P = 0.19) all conferred a high risk for developing DFU in our study population. Overall assessment showed that the prevalence of “foot-at-risk' in this study was 30.5% which we think is substantial enough to attract a more serious attention.
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