Ⅱ型糖尿病患者前行和倒走时的足底压力变化

目的 探讨Ⅱ型糖尿病患者前行与倒走时的足底压力与足部知识及自护行为的情况,为临床寻求减少糖尿病足发生率的方法提供依据.方法 对医院收治的105例Ⅱ型糖尿病患者设为观察组,同期选择在医院进行健康体检的105名正常人为对照组,检测两组足底压力及压力中心轨迹变化,并对观察组进行足部知识自护问卷调查.结果 与对照组相比,观察组在第2～5趾、第2跖骨区的峰值压力显著降低,差异具有统计学差异（P＜0.05）,而在第3跖骨、第1跖骨、足跟内侧这三个区域双足底的压力均增大（P＜0.05）;与前行时相比,观察组患者倒走时在第1趾、第2～5趾、第1跖骨、足中部或足弓、足跟内侧、足跟外侧等各个区域的双足足底峰值压力均有不同程度的增加（P＜0.05）;但在第3跖骨区域倒走时双足压力却较前行时显著降低（P＜0.05）;观察组倒走时的足底压力中心轨迹在X轴上的位移相比于前行时显著增大（P＜0.05）,但在Y轴上的位移则明显减小（P＜0.05）,双足在位移上差异不大;Ⅱ型糖尿病患者问卷总分为（20.64±3.47）分.结论 糖尿病患者前行时足底压力分布与正常人存在差异;倒走时较前行时足底压力区域分布更为均匀,前足掌压力减轻,缓解了该区疲劳损伤,能起到预防糖尿病的作用;应加强对糖尿病患者足部保护知识及自护行为的教育指导,减少糖尿病足的发生率.

Plantar pressure analysis of patients with type 2 diabetes mellitus in forward and backward walk

Objective To explore the plantar pressure,foot self-care knowledge and behavior of patients with type 2 diabetes mellitus in forward and backward walk and find ways to reduce the incidence of diabetic foot.Methods 105 patients with type 2 diabetes mellitus were in observation group and 105 normal healthy people were as the control group.The plantar pressure and pressure center trajectory and the observation group for foot self-care knowledge questionnaire were observed.Results Compared with the control group,the peak pressure of the 2-5 toe and second metatarsal region of the observation group significantly decreased （P〈0.05）.In the third metatarsal,the first metatarsal and medial heel,the pressure at the end feet were increased （P〈0.05）.The plantar peak pressure in districts of the first toe,2-5 toe,the first metatarsal,or mid-foot arch,medial heel and Lateral heel during backward walking in observation group had different degrees of increase （P〈0.05）.But in the third metatarsal area feet go down pressure is significantly lower than the previous row （P〈0.05）.The center of the track of the plantar pressure during backward walking in the X-axis displacement compared to the previous line increased significantly （P〈0.05）.But in the Y-axis displacement was significantly reduced （P〈0.05）.Conclusion There are differences in plantar pressure between the healthy people and patients with type 2 Diabetes Mellitus during forward walking.The peak pressure of plantar districts may be distributed better in patients with type 2 Diabetes Mellitus during backward walking,and the forefoot pressure may be relieved.The patients with type 2 Diabetes Mellitus should be strengthened knowledge of foot protection and self-care behavior of patients with educational guidance,to reduce the incidence of diabetic foot.