本文選題：糖尿病足　切入點(diǎn)：TASC分級　出處：《中華醫(yī)院感染學(xué)雜志》2017年20期

【摘要】：目的探討細(xì)菌感染對糖尿病足患者下肢血管病情的影響。方法收集2015年6月-2016年8月于醫(yī)院住院治療的糖尿病足伴細(xì)菌感染患者88例,依據(jù)泛大西洋學(xué)會聯(lián)盟(TASC)分級(A~D)將患者分為A組24例、B組25例、C組20例、D組19例。比較四組患者間一般資料和實(shí)驗(yàn)室檢查指標(biāo)如踝肱指數(shù)(ABI)、趾肱指數(shù)(TBI)、白細(xì)胞計(jì)數(shù)等;收集患者足部潰瘍分泌物做細(xì)菌培養(yǎng)和藥敏實(shí)驗(yàn)。結(jié)果從A組到D組,患者年齡、病程、中性粒細(xì)胞比例逐漸增加(P0.05),ABI和TBI逐漸降低(P0.05),重度感染比例、混合感染比例逐漸上升(P0.05);細(xì)菌培養(yǎng)共檢出病原菌195株,其中革蘭陰性菌102株占52.31%,革蘭陽性菌79株占40.51%,真菌14株占7.18%;藥敏結(jié)果顯示,主要革蘭陰性菌對阿米卡星、亞胺培南等抗菌藥物較敏感,主要革蘭陽性菌均對達(dá)福普丁和萬古霉素等較敏感。結(jié)論糖尿病足患者下肢感染與血管病變明顯相關(guān),隨著下肢血管病變發(fā)展,混合感染比例隨之升高,感染程度也越來越嚴(yán)重,建議使用敏感抗菌藥物進(jìn)行抗感染治療。
[Abstract]:Objective to investigate the effect of bacterial infection on the condition of lower extremity vessels in diabetic foot patients.Methods from June 2015 to August 2016, 88 cases of diabetic foot with bacterial infection were collected and divided into two groups: group A (24 cases), group B (25 cases), group C (20 cases) and group D (19 cases).The general data and laboratory indexes such as ankle brachial index (ABI), toe brachial index (TBI), white blood cell count (WBC) were compared among the four groups, and bacterial culture and drug sensitivity tests were done by collecting the secretion of foot ulcer.Results from group A to group D, the proportion of neutrophils increased gradually, the proportion of neutrophils increased gradually, the proportion of severe infection and the proportion of mixed infection increased gradually, and 195 strains of pathogenic bacteria were detected in bacterial culture.Among them, 102 strains of Gram-negative bacteria accounted for 52.31%, 79 strains of Gram-positive bacteria accounted for 40.51% and 14 strains of fungi accounted for 7.18.The drug sensitivity results showed that the main gram-negative bacteria were sensitive to amikacin, imipenem and other antimicrobial agents.The main gram-positive bacteria were sensitive to Dafopudine and vancomycin.Conclusion the infection of lower extremity is associated with vascular disease in diabetic foot patients. With the development of vascular disease of lower extremity, the proportion of mixed infection increases and the degree of infection becomes more and more serious. It is suggested that sensitive antimicrobial agents should be used for antiinfective therapy.
【作者單位】： 儋州市人民醫(yī)院內(nèi)分泌科;海南西部中心醫(yī)院內(nèi)分泌科;儋州市人民醫(yī)院呼吸內(nèi)科;
【基金】：海南省衛(wèi)生廳科學(xué)研究基金資助項(xiàng)目(1421000320A2004)
【分類號】：R587.2
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本文編號：1714786