社区老年糖尿病患者足部皮肤问题现状调查与分析

目的 了解老年糖尿病患者足部皮肤受损情况及其相关因素,为采取针对性预防措施提供参考。 方法 采用自行设计的足部皮肤评估表对上海地区5个社区的411例老年糖尿病患者足部皮肤情况进行现状调查。 结果 社区老年糖尿病患者足部皮肤受损的发生率为50.1%。良好的自我管理行为、及时就诊为保护因素;年龄、高血脂、糖尿病周围神经病变为危险因素（均P＜0.05）。 结论 老年糖尿病患者足部皮肤受损发生率高,且受多种因素影响。应提升患者的自我管理行为、及时就诊,定期进行高血脂、糖尿病周围神经病变筛查及干预,以预防糖尿病足的发生。     

足部护理对糖尿病周围神经病变预后的影响

目的 探讨足部护理对糖尿病周围神经病变患者下肢神经传导速度及症状的影响.方法 将42例2型糖尿病周围神经病变患者随机均分为对照组和观察组各21例,两组均给予糖尿病饮食和规范的降血糖治疗,控制血糖达标,同时配合活血化淤类药物及营养神经治疗.观察组在此基础上配合实施足部护理,教育指导,时间3个月.评价治疗前后患者双侧腓神经和胫后神经感觉神经传导速度及双下肢症状改善情况.结果 观察组治疗效果和感觉神经传导速度改善状况显著优于对照组(P＜0.05,P＜0.01).结论 足部护理有利于糖尿病周围神经病变患者下肢神经传导速度的恢复及症状改善,有利于预防糖尿病足的发生.     

足部护理对糖尿病周围神经病变预后的影响

目的探讨足部护理对糖尿病周围神经病变患者下肢神经传导速度及症状的影响。方法将42例2型糖尿病周围神经病变患者随机均分为对照组和观察组各21例，两组均给予糖尿病饮食和规范的降血糖治疗，控制血糖达标，同时配合活血化淤类药物及营养神经治疗。观察组在此基础上配合实施足部护理．教育指导，时间3个月。评价治疗前后患者双侧腓神经和胫后神经感觉神经传导速度及双下肢症状改善情况。结果观察组治疗效果和感觉神经传导速度改善状况显著优于对照组（P〈0．05。P〈0．01）。结论足部护理有利于糖尿病周围神经病变患者下肢神经传导速度的恢复及症状改善，有利于预防糖尿病足的发生。     

聊城市新生儿听力筛查开展现状及影响因素分析

目的:了解聊城市新生儿听力筛查的现状,探讨本地区开展新生儿听力筛适宜的模式.方法:以2009年出生于聊城市九个区县的71797例新生儿为研究对象.应用瞬态诱发性耳声发射技术对出生3天的新生儿进行听力初筛,未通过初筛的在产后42天以同样的方法进行复筛,仍未通过者,应用听觉脑干诱发电位技术检查确诊听力障碍程度,并跟踪随访.结果:初筛59376例,初筛率为82.70％,其中NICU高危因素患儿2432例,普通病房56944例;初筛通过53952例,未通过5424例,复筛1971例,复筛率为36.33％,确诊102例,先天性听力损失的检出率1.72‰,NICU患儿检出率2.55％,普通病房检出率0.07％.其中81例接受听力评估和治疗.结论:聊城市新生儿筛查覆盖率不高,经济和文化水平影响听力筛查工作的开展,治疗方式应系统化.     

中文版糖尿病足风险筛查及分级工具预测效果检验

目的 翻译并评价中文版糖尿病足风险筛查及分级工具,并验证其信效度及预测效果,为临床快速筛查提供工具.方法 根据跨文化研究指南对糖尿病足风险筛查及分级工具进行汉化,并对356例糖尿病患者进行糖尿病足风险筛查,评定此筛查工具信效度.结果 中文版糖尿病足风险筛查及分级工具有6个维度14个条目,筛查工具内容效度指数(S-CVI...     

老年糖尿病患者照顾者足部护理知识和行为调查

目的了解老年糖尿病患者照顾者足部护理知识掌握情况及其行为,针对性地做好该组人群的健康教育,有效预防糖尿病足的发生。方法自行设计调查问卷,采用方便取样法,调查309名老年糖尿病患者照顾者的一般情况、足部护理知识及行为。结果照顾者中80.3%文化程度为初中、小学或文盲;仅31.7%的照顾者知晓清洗足部的水温范围,28.5%知道清洗足部的时间,42.7%知道擦拭足部重点部位,26.9%知道如何检查,34.6%知道足部按摩的方法,30.7%知道下肢运动的方法;对糖尿病足有防范意识的照顾者占33.7%,认为糖尿病足的发生是护理不当的结果者占32.0%。结论中青年、非亲属、低文化者是长期住院老年糖尿病患者的主要照顾人员,其足部护理知识缺乏,预防意识薄弱。应定期对新入院患者的照顾者及新更换的照顾者进行足部护理知识的培训,提高其对糖尿病足的防范意识,并定期检查其措施落实情况,以预防糖尿病足的发生。     

胃癌风险人群筛查及危险因素分析

目的 对胃癌风险人群进行筛查,对危险因素进行分析。方法 选择本院自行设计胃癌危险因素问卷对研究对象进行调查,并对具有不同人口学特征和胃癌行为危险因素的研究对象进行分析。采用Logistic回归对胃癌的危险因素进行分析。结果 单因素分析结果指出：患者的年龄、性别、职业、婚姻状况、生活所在地、经济收入、教育水平、饮食清淡度、胃部相关疾病、饮食清淡度、腌制食品摄入、吸烟、饮酒、饮食规律度、胃癌家族史、癌症家族史与胃癌的发生相关,差异有统计学意义（P<0.05）;果蔬摄入情况与胃癌的发生无关,差异无统计学意义（P>0.05）。多因素分析结果指出年龄、性别、婚姻状况、生活所在地、经济收入、腌制食品摄入、饮食清淡度、饮食规律度、吸烟、饮酒、胃部相关疾病、胃癌家族史是胃癌的危险因素（P<0.05）。结论 年龄、性别、婚姻状况、生活所在地、经济收入、腌制食品摄入、饮食清淡度、饮食规律度、吸烟、饮酒、胃部相关疾病、胃癌家族史是胃癌的危险因素。医务人员需要结合风险人群的危险因素具体情况开展个体化指导干预,提高胃癌风险人群的认知水平,以降低发生胃癌的风险。     

农村高血压患者居家安全风险现状及影响因素分析

目的 探讨农村高血压患者居家安全风险现状及其影响因素.方法 采用农村高血压患者居家安全风险评估问卷对丽水市九县下属农村地区的328例高血压患者进行调查.结果 农村高血压患者居家安全风险得分为(135.10±20.69)分.多元回归分析显示,年龄、学历、婚姻状况、医疗保险、高血压分期是影响农村高血压患者居家安全风险的主要...     

糖尿病患者自我厌恶现状及影响因素分析

目的 了解糖尿病患者自我厌恶现状及其影响因素,为医护人员采取针对性干预改善糖尿病患者心理健康提供参考。方法 采用一般情况调查表、自我厌恶量表、医学应对问卷和领悟社会支持量表对274例2型糖尿病患者进行调查。结果 糖尿病患者自我厌恶得分（35.46±6.39）分,年龄、糖尿病相关并发症、回避应对、领悟社会支持总分是自我厌恶的主要影响因素（均P＜0.05）,可预测总变异的49.6%。结论 糖尿病患者自我厌恶为中等偏高水平,护理人员应加强对糖尿病患者自我厌恶水平的评估和筛查,加强对年轻、有糖尿病相关并发症的患者的干预,帮助患者减少其回避行为,并增强其领悟社会支持水平,从而降低其自我厌恶水平。     

糖尿病足高危患者足部自护行为及影响因素研究

目的 描述糖尿病足高危患者的足部自护行为及其阶段分布,并进行影响因素分析.方法 对343例糖尿病足高危患者应用一般资料问卷、糖尿病患者足部护理行为问卷、行为阶段表、第三版糖尿病态度量表、社会支持评定量表和糖尿病自我效能量表进行横断面调查.结果 糖尿病足高危患者的足部自护行为得分28～68(47.50±7.30)分,百分制标准得分为59.81分.足部自护行为意图前期、意图期、准备期、行动期和维持期分别为11.7％、35.6％、41.7％、5.8％和5.2％.有序Logistic回归分析显示:性别、支付方式、感知社会榜样、疾病认知态度和自我效能是影响患者行为阶段分布的主要因素(P<0.05,P<0.01).结论 糖尿病足高危患者的足部护理行为总体水平低,多数患者的足部自护行为处于前期阶段;患者的足部自护行为受多种因素影响,医务人员应结合相关因素,对不同行为阶段的患者采取针对性干预策略,以促进其足部自护行为的阶段性转变.     

Foot complications in patients with diabetes

Foot complications are a common cause of hospital admission of patients with diabetes and a frequent cause of amputation. Neuropathy and arterial disease make the foot particularly vulnerable, but infection is often the final presenting complication. Recognition of the patient at risk may prevent the development of foot complications initially, but if they occur urgent treatment is required to prevent limb loss. The infected foot in a patient with diabetes is a surgical emergency. In addition to antibiotics, debridement and surgical drainage of infection should be considered within the first 24 hours. Once the foot is made safe, revascularization should be undertaken in those with significant arterial disease. Adoption of a multidisciplinary team approach to managing diabetic foot complications has resulted in reduction in major amputation in some European countries.     

Foot complications in patients with diabetes

Foot complications are a common cause of hospital admission of patients with diabetes and a frequent cause of amputation. Neuropathy and arterial disease make the foot particularly vulnerable, but infection is often the final presenting complication. Recognition of the patient at risk may prevent the development of foot complications initially, but if they occur urgent treatment is required to prevent limb loss. The infected foot in a patient with diabetes is a surgical emergency. In addition to antibiotics, debridement and surgical drainage of infection should be considered within the first 24 hours. Once the foot is made safe revascularization should be undertaken in those with significant arterial disease. Adoption of a multidisciplinary team approach to managing diabetic foot complications has resulted in reduction in major amputation in some European countries.     

Foot complications in patients with diabetes

Foot complications are a common cause of hospital admission of people with diabetes and a frequent cause of amputation. Neuropathy and arterial disease make the foot particularly vulnerable, but infection is often the pathology precipitating presentation. Recognition of the patient at risk may prevent the development of foot complications, but if they do occur urgent treatment is required to prevent limb loss. The infected foot in a patient with diabetes is a surgical emergency. In addition to antibiotics, debridement and surgical drainage of infection should be considered within the first 24 hours. Once the foot is made safe, revascularization should be undertaken in those with significant arterial disease. Adoption of a multidisciplinary team approach to managing diabetic foot complications has resulted in reduction in major amputations in some European countries.     

Foot complications in patients with diabetes

Foot complications are a common cause of hospital admission of people with diabetes and a frequent cause of amputation. Neuropathy and arterial disease make the foot particularly vulnerable, but infection is often the pathology precipitating presentation. Recognition of the patient at risk may prevent the development of foot complications, but if they do occur urgent treatment is required to prevent limb loss. The infected foot in a patient with diabetes is a surgical emergency. In addition to antibiotics, debridement and surgical drainage of infection should be considered within the first 24 hours. Once the foot is made safe, revascularization should be undertaken in those with significant arterial disease. Adoption of a multidisciplinary team approach to managing diabetic foot complications has resulted in reduction in major amputations in some European countries.     

Foot complications in patients with diabetes

Foot complications are a common cause of hospital admission of patients with diabetes and a frequent cause of amputation. Neuropathy and arterial disease make the foot particularly vulnerable, but infection is often the final presenting complication. Recognition of the patient at risk may prevent the development of foot complications initially, but if they occur rapid treatment is required to prevent limb loss. The infected foot in a patient with diabetes is a surgical emergency. In addition to antibiotics, debridement and surgical drainage of infection should be considered within the first 24 hours. Once the foot is made safe revascularization should be undertaken in those with significant arterial disease. Adoption of a coordinated approach to managing diabetic foot complications has resulted in reduction in major amputation in some European countries.     

Risk factors that predict major amputations and amputation time intervals for hospitalised diabetic patients with foot complications

Diabetes‐related lower extremity amputations are an enormous burden on global health care and social resources because of the rapid worldwide growth of the diabetic population. This research aimed to determine risk factors that predict major amputation and analyse the time interval from first hospitalisation to amputation by using standard management protocols and Kaplan–Meier survival curves. Data from 246 patients with diabetes mellitus and diabetic foot ulcers from the Division of Plastic and Reconstructive Surgery of the Department of Surgery at XXX Hospital between January 2016 and May 2020 were analysed. Univariate and multivariate analyses of 44 potential risk factors, including invasive ulcer depth and C‐reactive protein levels, showed statistically significant differences for those at increased risk for major amputation. The median time from hospitalisation to lower extremity amputation was approximately 35 days. Most patients with abnormal C‐reactive protein levels and approximately 70% of patients with ulcers invading the bone were at risk for lower extremity amputations within 35 days. Therefore, invasive ulcer depth and C‐reactive protein levels are significant risk factors. Other potential risk factors for major amputation and the time intervals from first hospitalisation to amputation should be analysed to establish further prediction strategies.     

2型糖尿病患者的风险感知及影响因素分析

目的了解2型糖尿病患者的风险感知水平及其影响因素。方法采用糖尿病相对性风险感知问卷对268名2型糖尿病患者进行调查。结果相对性风险感知总得分2.55±0.37,各维度得分由高到低依次为:担心3.39±0.51,相对性环境风险2.84±0.39,个人风险控制2.74±0.47,乐观性偏差2.52±0.67,个人疾病风险2.17±0.78。女性及文化程度高者感知的个人风险控制和乐观性偏差显著高于男性及文化程度低者(P0.05,P0.01),非在岗者的担心水平显著高于在岗者(P0.05)。相对性风险感知总分与病程呈正相关(P0.01),个人风险控制与空腹血糖呈负相关(P0.05),个人疾病风险与年龄、病程呈正相关(均P0.01)。乐观性偏差、病程、年龄、个人风险控制、担心、家庭月收入是个人感知的疾病风险的独立影响因素。结论 2型糖尿病患者的风险感知水平偏低,应根据不同人口学特征和疾病临床特征,采取有效的健康风险沟通和个性化健康干预。     

Effect of diabetic foot ulcers and other risk factors on the prevalence of lower extremity amputation: A meta-analysis

A meta-analysis study was conducted to measure the consequence of diabetic foot ulcers (DFUs) and other risk factors (RFs) on the prevalence of lower extremity amputation (LEA). A comprehensive literature inspection till February 2023 was applied and 2765 interrelated studies were reviewed. Of the 32 chosen studies enclosed, 9934 subjects were in the chosen studies' starting point, and 2906 of them were with LEA. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of DFUs and other RFs on the prevalence of LEA by the continuous and dichotomous approaches and a fixed or random effect model. Male gender (OR, 1.30; 95% CI, 1.17–1.44, P < .001), smoking (OR, 1.24; 95% CI, 1.01–1.53, P = .04), previous foot ulcer (OR, 2.69; 95% CI, 1.93–3.74, P < .001), osteomyelitis (OR, 3.87; 95% CI, 2.28–6.57, P < .001), gangrene (OR, 14.45; 95% CI, 7.03–29.72, P < .001), hypertension (OR, 1.17; 95% CI, 1.03–1.33, P = .01), and white blood cells count (WBCC) (MD, 2.05; 95% CI, 1.37–2.74, P < .001) were significantly shown to be an RF in LEA in subjects with DFUs. Age (MD, 0.81; 95% CI, −0.75 to 2.37, P = .31), body mass index (MD, −0.55; 95% CI, −1.15 to 0.05, P = .07), diabetes mellitus type (OR, 0.99; 95% CI, 0.63–1.56, P = .96), and glycated haemoglobin (MD, 0.33; 95% CI, −0.15 to 0.81, P = .17) were not shown to be an RF in LEA in subjects with DFUs. Male gender, smoking, previous foot ulcer, osteomyelitis, gangrene, hypertension, and WBCC were significantly shown to be an RF in LEA in subjects with DFUs. However, age and diabetes mellitus type were not shown to be RF in LEA in subjects with DFUs. However, caused of the small sample sizes of several chosen studies for this meta-analysis, care must be exercised when dealing with its values.     

Foot complications in people with diabetes

Foot complications are the most common cause of hospital admission of people with diabetes and a frequent cause of amputation. Neuropathy and peripheral arterial disease make the foot particularly vulnerable to ulceration, but infection is often the pathology precipitating presentation. Recognition of the patient at risk of ulceration may allow interventions to prevent the development of foot complications. When complications do occur, urgent treatment is required to prevent limb loss; the infected foot in a patient with diabetes is a surgical emergency. In addition to antibiotics, debridement and surgical drainage of infection should be considered within the first 24 hours after presentation. Once the foot is made safe, revascularization should be undertaken in those with significant arterial disease. Adoption of a multidisciplinary team approach to managing diabetic foot complications has resulted in reduction in major amputations in some European countries.