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Diabetic foot

内分泌

关键词内分泌 疾病 组织病变

词汇介绍

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解析

diabetic   英 /daɪə'betɪk/   美 /,daɪə'bɛtɪk/

释    义   adj. 糖尿病的,患糖尿病的; n. 糖尿病患者

同根词   diabetes n. 糖尿病;多尿症

例    句   Diabetic kidney disease can be prevented by keeping blood sugar in your target range. 糖尿病肾病可以通过保持血糖在你的目标范围内来预防。

 

foot   英 /fʊt/   美 /fʊt/

释    义   n. 脚;英尺;步调;末尾

               vi. 步行;跳舞;总计

               vt. 支付;给……换底

               n. (Foot)人名;(英)富特

例    句   In its own way on foot to see how you go. 路就在自己的脚下,就看你怎么走了。

概述

糖尿病足是指因糖尿病血管病变和(或)神经病变和感染等因素单独或复合作用导致的糖尿病患者足部或下肢组织破坏的一种病变,是威胁糖尿病患者的严重并发症。诊断标准①有明确的糖尿病史并且有肢端病变者。②肢端可表现为皮肤干燥瘙痒、汗毛脱落、趾甲变形等营养不良状态。或肢端皮温低,动脉搏动减弱或消失,间歇性跛行史及静息痛等缺血表现。或肢端刺疼、灼疼、麻木、感觉迟钝或丧失等神经损伤表现。③部分病人表现肢端皮肤干裂或水疱、血疱、糜烂、各种类型坏疽(以趾端开始的干性坏疽为主)或坏死。④相关医技检查,满足以下任意一

A Prospective, Multicenter, Single-Arm Clinical Trial for Treatment of Complex Diabetic Foot Ulcers with Deep Exposure Using Acellular Dermal Matrix复制标题

应用脱细胞真皮基质深度暴露治疗复杂性糖尿病足溃疡的前瞻性、多中心、单臂临床试验

发表时间:2019-09-01

影响因子:1.4

作者: Shawn Cazzell

期刊:Adv Skin Wound Care

A major limitation of this study was the lack of a control arm. The authors believe that the efficacy of the D-ADM was supported because of rapid granulation and wound area reduction. Although it is not possible to make direct comparisons to results from standard of care, the outcomes using D-ADM can be compared with results reported in the literature. For example, the product’s efficacy was supported by the average number of applications required to induce granulation (1.2) and healing (1.0). These averages are in sharp contrast to the 9.0 and 6.8 mean applications, respectively, reported for a vCHPM.12 Another major limitation was that the study follow-up terminated after 16 weeks, which provided an insufficient length of time for the extremely large ulcers to heal. Future studies that include Wagner grades 3 and 4 DFUs would benefit from a longer study duration. In addition, hemoglobin A1c levels were recorded for only 16 patients (mean hemoglobin A1c = 8.0%) because that information was charted well before informed consent was obtained for the other participants. Because that information was not available, study authors collected concomitant medications and antidiabetic regimens for those 59 participants with a diagnosis of diabetes: 13 were treated with 1 or more oral agents, 20 with insulin, 23 with both insulin and oral agents, and 2 with diet and exercise. The biases encountered for natural recovery or healing and use of adjunctive therapies were considered during protocol design. The protocol required the target wounds to have shown little response to standard-of-care wound therapies for at least 4 weeks prior to the screening visit. Criteria also dictated that the wounds required aggressive surgical debridement in addition to a documented need for the use of a CTP. Hyperbaric oxygen treatments were not allowed as an adjunct treatment during the trial. Those participants who required additional surgical intervention on the target limb during the treatment period were withdrawn from the trial.

译文

该研究的一个主要局限是缺乏对照组。作者认为,由于快速造粒和伤口面积减少,D-ADM的功效得到了支持。虽然不可能直接与标准治疗结果进行比较,但可以将使用D-ADM的结果与文献中报道的结果进行比较。例如,产品的功效由诱导造粒(1.2)和愈合(1.0)所需的平均应用数量支持。这些平均值与vCHPM报告的9.0和6.8平均应用形成鲜明对比.12另一个主要限制是研究随访在16周后终止,这为极大的溃疡提供了不足的时间长度。愈合。包括Wagner 3级和4级DFU在内的未来研究将受益于更长的研究持续时间。此外,仅记录16名患者的血红蛋白A1c水平(平均血红蛋白A1c = 8.0%),因为在获得其他参与者的知情同意之前,该信息已被很好地绘制。由于没有该信息,研究作者为59名诊断为糖尿病的参与者收集了伴随药物和抗糖尿病治疗方案:13名患者接受了1种或更多口服药物治疗,20名接受了胰岛素治疗,23名接受了胰岛素和口服药物治疗,2名接受了饮食和运动。在方案设计期间考虑了自然恢复或愈合以及辅助治疗的使用所遇到的偏差。该方案要求目标伤口在筛选就诊前至少4周对标准护理伤口疗法几乎没有反应。标准还规定,除了记录使用CTP的需要外,伤口还需要积极的外科清创术。在试验期间不允许高压氧治疗作为辅助治疗。在治疗期间需要对目标肢体进行额外手术干预的那些参与者退出试验。