糖尿病足高危患者及其足部护理状况调查

目的了解住院糖尿病患者中糖尿病足高危人群的比例及其足部护理状况。方法方便取样,选择101例住院糖尿病患者,采用Semmes Weistein 5.07/10g单尼龙丝检查患者压力觉,128兆音叉测定患者震动觉,两者相结合筛查糖尿病足的高危人群,同时应用糖尿病控制状况评价量表(CSSD70)以及病历回顾等方法了解患者发生糖尿病足的危险因素、血糖控制情况(空腹血糖、糖化血红蛋白)以及患者目前足部自我护理状况。结果101例患者中86例(85.1%)为高危,正常者仅为15例(14.9%)。高危患者中压力觉异常者为61例(60.4%),振动觉异常者为85例(84.2%)。压力觉和振动觉得分均与糖化血红蛋白呈正相关(r=0.25,r=0.27,P<0.01),与年龄呈负相关(r=-0.28,r=-0.40,P<0.01)。高危组和正常组患者糖尿病控制状况评价量表总分和各模块得分无显著差异。患者每天检查双脚,穿鞋前检查鞋内异物及不应赤脚行走,不穿有破洞、打补丁的袜子等方面的知识较欠缺,行为不健康。结论住院糖尿病患者中糖尿病足的高危人群比例相当高,存在生活习惯、治疗情况、生存技能、治疗目标和疾病知识等方面问题较多,足部护理状况令人担忧,提示应加强住院患者的筛查、教育与管理。

Investigation of patients with high risk of diabetes foot and their foot care status

Objective To investigate the prevalence of patients with high risk of diabetes foot in inpatients with diabetes mellitus and their foot care status. Methods One hundred and one patients were included with convenient sampling. Semmes Weistein 5.07/10 monofiliment and 128 Mhz vibration fork were adopted to screen the high risk foot. Diabetes control status questionnaire(CSSD70) and review of medical record were conducted to assess the risk factors, diabetes control including fasting blood glucose and HbA1c and patients current foot care status. Results 86(85.1%) cases out of 101 were with high risk of diabetes foot, and those normal only account for 14.9%. 61(60.4%) cases were with abnormal press sensation and 85(84.2%)cases were with abnormal vibration sensation. The degree of abnormality of press sensation and vibration sensation was positively correlated with HbA1c(r=0.25, r=0.27,P<0.01)and negatively correlated with age(r=-0.28,r=-0.40,P<0.01). There were no significant difference in CSSD70 score between high risk group and normal group. Conclusions The prevalence of patients with high risk of diabetes foot was high among diabetes inpatients. They had poor knowledge and skills in life style, diabetes treatment, survival skills and disease management. Their foot care status was very worrying. High risk patients' screening, education and management should be enhanced.