内分泌
词汇介绍
拓展阅读
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
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，满足以下任意一项者。踝/臂血压指数小于0.9以下者。超声彩色多普勒检查提示肢端血管变细，血流量减少造成缺血或坏疽者。血管造影证实，CTA、MRA提示血管腔狭窄或阻塞，并有临床表现者。电生理检查，可见周围神经传导速度减慢或肌电图、体感诱发电位异常改变者。X线检查，可见骨质疏松脱钙、骨质破坏、骨髓炎或关节病变、手足畸形及夏科关节等改变者。
治疗
糖尿病足的治疗具有挑战性和时间周期长的特点，治疗方法包括矫形器具，抗菌药物和局部敷料。大多数糖尿病足感染（DFI）需要使用全身性抗生素治疗。初始抗生素治疗的选择取决于几个因素，例如感染的严重程度，患者是否接受了另一种抗生素治疗，以及感染是否是由已知对常规耐药的微生物引起的。抗生素治疗的目的是阻止感染并确保其不会扩散。尚不清楚任何特定的抗生素是否比任何其他抗生素更好地治愈感染或避免截肢。含有或不含万古霉素的厄他培南比替加环素更有效地治疗DFIs。通常还不清楚不同的抗生素是否与更多或更少的副作用相关。
然而，建议用于治疗糖尿病足溃疡的抗生素应在伤口深层组织培养后使用。应该进行组织培养而不是脓拭子培养。抗生素应以正确的剂量使用，以防止出现耐药性。目前尚不清楚局部抗生素是否能改善手术后的预后。
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
影响指数：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
