于世界糖尿病日重谈糖尿病足的诊治与预防

糖尿病足治疗困难，医疗费用高。临床处理时，首先要明确糖尿病足的主要病因因素，如神经性、缺血性或神经缺血性以及是否合并感染，并根据常用的糖尿病足Wagner分级法来判断糖尿病足的严重程度，以采取相应的治疗措施，如神经性溃疡应减轻局部压力和纠正局部的畸形，周围血管病变则采用内科治疗和介入或外科治疗，感染的局部处理和全身用药等。糖尿病足的防治必须强调多学科合作和综合治疗，预防的重点在于开展糖尿病足危险因素筛查并给予纠正。

Reiteration of dignosis, management and prevention of diabetic foot on the World Diabetes Day

Diabetic foot ulcers are primarily due to neuropathy and/or ischemia, and frequently complicated by infection, Feet can be stratified for risk of ulceration according to the presence of neuropathy, peripheral vascular disease and deformity. Ulcer can be classified according to the Wagner Classification System to predict prognosis and the risk of amputation. The management of the foot problems differs with neuropathy, peripheral vascular disease, and infections. Prevention is more emphasized than the treatment in decreasing diabetic amputation, particularly in the patients with high risk factors of foot problems.