糖尿病夏科足临床特点分析

目的总结糖尿病夏科足的临床特点,提高临床医师对于本病的认识。方法回顾性分析11例2型糖尿病夏科足患者的临床特点。结果 11例患者中,男7例,女4例;平均年龄(60±11)岁;平均糖尿病病程16年;全部合并神经病变而无下肢血管病变;单侧足病变10例,双足病变1例;3例发病前有明确的外伤史。影像学表现为足部骨质破坏7例,关节间隙变窄6例,软组织肿胀3例,关节半脱位2例,关节融合2例,碎骨1例。11例患者一入院均遵医嘱限制活动。对足溃疡给予积极清创,换药。根据细菌培养及药敏试验结果选用抗生素治疗。10例合并足溃疡病例中,1例截趾后愈合,3例愈合,5例好转,1例自动出院后失访。3例出院后有足溃疡的复发。结论早期识别并给予制动等措施有助于足溃疡愈合和减缓夏科足畸形的发展。

Clinical Characteristics of Charcot Foot in Patients with Diabetes:A Report of Eleven Cases

Objective To summarize the clinical features of Charcot foot in diabetes and to improve the understanding of Charcot′s Foot in physicians.Methods Clinical features of 11 type 2 diabetes patients with Charcot foot were retrospectively analyzed.Results Of the 11 patients,7 were male and 4 were female with an average age of(60±11) and average diabetes history of 16 years.All the patients were accompanied with neuropathy but without lower extremity microangiopathy.10 patients had unilateral foot lesion and 1 case had bilateral feet lesion.3 cases had definite history of trauma before onset.Imaging showed that 7 cases had bone destruction,6 cases had narrowed joint space,3 cases had swollen soft tissues,2 cases had subluxation,2 cases had joint fusion,and 1 case had broken bone.The activities of the 11 patients were restricted by following the doctor′s advice.Foot ulcer was given positive debridement and the ulcer′s dressings were also changed.Antibiotics were selected according to the results of bacteria culture and drug sensitive test.Of the 10 patients accompanied with foot ulcer,1 case healed after toe amputation,3 cases healed,5 cases were improved and 1 case was lost to following up.3 cases relapsed into foot ulcer after discharge from hospital.Conclusion Early diagnosis and immobilization are beneficial for the healing of foot ulcer and can inhibit the development of Charcot foot.