摘要
目的分析糖尿病足溃疡(DFU)患者伤口愈合后复发的主要危险因素,为临床预防DFU的复发提供依据。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方数据库、维普中文科技期刊全文数据库、中国生物医学文献数据库,搜集建库至2021年7月10日关于DFU患者复发危险因素的文献,采用RevMan 5.3软件进行Meta分析。结果最终纳入12篇文献,共计患者2585例,其中累计复发组982例,未复发组1603例。Meta分析结果显示,Wagner分级(Ⅲ、Ⅳ级)(OR=4.40,95%CI:2.21~8.78,P<0.01)、伴有周围神经病变(OR=5.69,95%CI:4.53~7.14,P<0.01)、伴有周围血管病变(OR=3.54,95%CI:3.05~4.11,P<0.01)、多重耐药菌感染(OR=3.61,95%CI:3.13~4.17,P<0.01)、截肢史(OR=19.18,95%CI:10.69~34.42,P<0.01)、既往DFU的持续时间≥60 d(OR=1.02,95%CI:1.00~1.03,P<0.01)、血糖控制差(OR=3.39,95%CI:2.67~4.31,P<0.01)、潜在骨髓炎(OR=2.86,95%CI:2.29~3.58,P<0.01)、初发溃疡在足底(OR=2.80,95%CI:2.10~3.73,P<0.01)、吸烟(OR=2.30,95%CI:1.18~4.48,P=0.01)是DFU复发的危险因素。结论基于现有证据,Wagner分级(Ⅲ、Ⅳ级)、伴有周围神经病变、伴有周围血管病变、多重耐药菌感染、截肢史、既往DFU的持续时间≥60 d、血糖控制差、潜在骨髓炎、初发溃疡在足底、吸烟是DFU复发的危险因素。医务人员应重视这些影响因素,采取相应措施进行针对性预防,从而提高糖尿病足护理服务质量。
Objective To analyze the main risk factors of recurrence after wound healing in patients with diabetic foot ulcer(DFU),so as to provide a basis for clinical prevention of DFU recurrence.Methods Cochrane Library,PubMed,Embase,Web of Science,CNKI,Wanfang Database,VIP Chinese Science and Technology Journal Full-text Database,and China Biomedical Literature Database were searched by computer,and the risk factors for recurrence of DFU patients were collected from the establishment of the databases to July 10,2021.Meta-analysis was performed using RevMan 5.3 software.Results Finally,12 articles were included,with a total of 2585 patients,including 982 cases in the recurrence group and 1603 cases in the non-recurrence group.Meta-analysis results showed that Wagner grade(gradeⅢ,Ⅳ)(OR=4.40,95%CI:2.21-8.78,P<0.01),accompanied by peripheral neuropathy(OR=5.69,95%CI:4.53-7.14,P<0.01),accompanied by peripheral vascular disease(OR=3.54,95%CI:3.05-4.11,P<0.01),multidrug-resistant infection(OR=3.61,95%CI:3.13-4.17,P<0.01),history of amputation(OR=19.18,95%CI:10.69-34.42,P<0.01),duration of previous DFU greater than or equal to 60 days(OR=1.02,95%CI:1.00-1.03,P<0.01),poor blood glucose control(OR=3.39,95%CI:2.67-4.31,P<0.01),underlying osteomyelitis(OR=2.86,95%CI:2.29-3.58,P<0.01),initial ulcer on the sole of the foot(OR=2.80,95%CI:2.10-3.73,P<0.01),smoking(OR=2.30,95%CI:1.18-4.48,P=0.01)were risk factors for DFU recurrence.Conclusions Based on the available evidence,Wagner grade(gradeⅢ,Ⅳ),accompanied by peripheral neuropathy,accompanied by peripheral vascular disease,multidrug-resistant infection,history of amputation,duration of previous DFU greater than or equal to 60 days,poor blood glucose control,underlying osteomyelitis,initial ulcer on the sole of the foot and smoking are risk factors for DFU recurrence.Medical staff should pay attention to these influencing factors and take corresponding measures for targeted prevention,so as to improve the quality of diabetic foot care services.
作者
夏磊
庄若
吴玲
魏敏
Xia Lei;Zhuang Ruo;Wu Ling;Wei Min(School of Nursing,School of Medicine,Jiangsu University,Zhenjiang 212001,China;Department of Nursing,Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China;Wound Care Clinic,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《中华现代护理杂志》
2022年第9期1143-1148,共6页
Chinese Journal of Modern Nursing
作者简介
通信作者:庄若,Email:1870502469@qq.com。
