International Journal of Clinical Research
International Journal of Clinical Research. 2025; 9: (2) ; 10.12208/j.ijcr.20250073 .
总浏览量: 61
1大理大学临床医学院 云南大理
2云南省第三人民医院内分泌科 云南昆明
*通讯作者： 桂莉,单位：大理大学临床医学院 云南大理；
DFU（diabetic foot ulcer, DFU）是糖尿病患者主要慢性并发症之一，也是导致糖尿病患者致残、致死的严重慢性并发症之一。DFU的创面治疗至关重要，DFU创面治疗包括内科治疗、创面处理治疗、外科治疗以及传统医药治疗，治疗方式及手段的更新进一步促进创面的愈合、改善DFU患者的生活质量，学习并掌握相关治疗新技术，可以促进足部溃疡的创面愈合，减少严重DFU，改善DF患者生活质量及预后情况，减少截肢率发生。本文根据目前国内外DFU相关传统及新型相关治疗方案和DF患者预防及教育等方面的进展进行综述，以期为临床促进糖尿病足部溃疡创面愈合、改善DFU患者预后提供理论支持。
Diabetic foot ulcer (DFU) is one of the main chronic complications of diabetes. It is also one of the serious chronic complications that can lead to disability and death in diabetic patients. DFU wound treatment is very important. DFU wound treatment includes medical treatment, wound treatment, surgical treatment and traditional medicine treatment. The renewal of treatment methods and means can further promote wound healing and improve the quality of life of DFU patients. Improve the quality of life and prognosis of DF patients and reduce the incidence of amputation. In this paper, according to the current domestic and foreign DFU-related traditional and new treatment schemes and DF patients prevention and education progress, in order to promote the clinical healing of diabetic foot ulcer wounds and improve the prognosis of DFU patients to provide theoretical support.
[1] Wukich D K, Crim B E, Frykberg R G, et al. Neuropathy and Poorly Controlled Diabetes Increase the Rate of Surgical Site Infection After Foot and Ankle Surgery[J]. Journal of Bone and Joint Surgery, 2014, 96(10): 832-839.
[2] 谷涌泉, 冉兴无, 郭连瑞, 等. 中国糖尿病足诊治指南[J]. 中国临床医生杂志, 2024, 52(11): 1287-1296.
[3] Lipsky B A, Berendt A R, Deery H G, et al. Diagnosis and Treatment of Diabetic Foot Infections[J]. Plastic and Reconstructive Surgery, 2006, 117(SUPPLEMENT): 212S-238S.
[4] 翟筱涵, 王爱红, 母义明. 糖尿病足感染病原学及抗感染治疗研究进展[J]. 中华医院感染学杂志, 2024，34(4): 635-640.
[5] F D, J M, H G, et al. Microbial Infection and Antibiotic Susceptibility of Diabetic Foot Ulcer in China: Literature Review[J]. Frontiers in endocrinology, 2022, 19(13)：881659.
[6] Em M, Sw B, Rs B. Diabetes-Related Foot Infections: Diagnosis and Treatment[J]. American family physician, 2021, 104(4)：386-394.
[7] Armstrong D G, Tan T W, Boulton A J M, et al. Diabetic Foot Ulcers[J]. JAMA, 2023, 330(1): 62.
[8] Pham T T, Gariani K, Richard J C, et al. Moderate to Severe Soft Tissue Diabetic Foot Infections: A Randomized, Controlled, Pilot Trial of Post-debridement Antibiotic Treatment for 10 versus 20 days[J]. Annals of Surgery, 2022, 276(2): 233-238.
[9] Gariani K, Pham T T, Kressmann B, et al. Three Weeks Versus Six Weeks of Antibiotic Therapy for Diabetic Foot Osteomyelitis: A Prospective, Randomized, Noninferiority Pilot Trial[J]. Clinical Infectious Diseases, 2021, 73(7): e1539-e1545.
[10] 梁桂花. 糖尿病足感染的细菌谱与抗生素应用分析[D]. 山东大学, 2023.
[11] 牛文芳, 朱平, 史琳涛, 等. 糖尿病足感染病原菌与Wagner分级相关性研究[J]. 世界临床药物, 2019, 40(10): 737-741.
[12] 刘春林, 徐波, 陈弟, 等. 感染性糖尿病足病原菌分布及耐药性分析[J]. 检验医学, 2019, 34(6): 513-517.
[13] 项阳, 姜壮, 职晓松, 等. 用于慢性创面治疗的局部抗菌肽制剂的研究进展[J]. 中国医药导报, 2023,20(22): 64-68.
[14] Chang M, Nguyen T T. Strategy for Treatment of Infected Diabetic Foot Ulcers[J]. Accounts of chemical research, 2021, 54(5): 1080-1093.
[15] Li X, Jing X, Yu Z, et al. Diverse Antibacterial Treatments beyond Antibiotics for Diabetic Foot Ulcer Therapy[J]. Advanced Healthcare Materials, 2023, 12(23):e2300375.
[16] 张云琪, 许宵钰, 马郭薇, 等. 糖尿病并发症发病机制及治疗药物研究进展[J]. 中国药理学通报, 2024,40(10): 1808-1813.
[17] 陈莉林, 曾茹. 氟哌噻吨美利曲辛片辅助阿片类止痛药物治疗中重度癌性疼痛临床观察[J]. 中国生化药物杂志, 2012, 33(6): 868-870.
[18] 2024中美脊髓电刺激管理慢性疼痛共识工作组. 脊髓电刺激管理慢性疼痛中美专家共识(2024)[J]. 协和医学杂志, 2024, 15(2): 285-293.
[19] 尹晶, 孙思思, 蔡猛, 等. 早期脊髓电刺激对大鼠脊髓损伤后疼痛的镇痛机制研究[J]. 中国疼痛医学杂志, 2024, 30(7): 494-500.
[20] Jiang P, Li Q, Luo Y, et al. Current status and progress in research on dressing management for diabetic foot ulcer[J]. Frontiers in Endocrinology, 2023, 17(14):1221705.
[21] 李欣, 周杰, 祁莉娜, 等. 普瑞巴林联合短时程脊髓电刺激治疗2型糖尿病伴带状疱疹后遗神经痛患者的效果观察[J]. 大医生, 2024, 9(21): 44-46.
[22] Donnelly H R, Clarke E D, Collins C E, et al. Most individuals with diabetes‐related foot ulceration do not meet dietary consensus guidelines for wound healing[J]. International Wound Journal, 2024, 21(3):e14483..
[23] Moore Z E, Corcoran M A, Patton D. Nutritional interventions for treating foot ulcers in people with diabetes[J]. Cochrane Database of Systematic Reviews, 2020, 17(7):11378.
[24] 石鸿雁, 朱平, 王爱红, 等. 糖尿病足溃疡的营养干预——《2022美国保肢学会专家共识和工作指南：成人糖尿病足溃疡的营养干预》的解读[J]. 感染、炎症、修复, 2022, 23(2): 70-78.
[25] Yue Wang, Lei Jun Wang, Hua Liang Li. 营养支持促进糖尿病足溃疡的愈合：案例研究（英文）[C]//Abstract Book of the 14th Asian Congress of Nutrition--Public Nutrition & Health. 中国四川成都, 2023: 1, 183.
[26] 国家老年医学中心, 中华医学会老年医学分会, 中国老年保健协会糖尿病专业委员会. 中国老年糖尿病诊疗指南(2024版)[J]. 协和医学杂志, 2024,15(4): 771-800.
[27] 孙小梅, 陈圆圆. 成人糖尿病病人低血糖评估的研究进展[J]. 全科护理, 2024, 22(22): 4195-4199.
[28] Hadar E, Chen R, Toledano Y, et al. Noninvasive, continuous, real-time glucose measurements compared to reference laboratory venous plasma glucose values[J]. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2019, 32(20): 3393-3400.
[29] 杨飞凤, 王喆, 李志强, 等. 连续血糖监测技术研究进展[J]. 中国医疗设备, 2024, 39(10): 159-164.
[30] Huang X, Yao C, Huang S, et al. Technological Advances of Wearable Device for Continuous Monitoring of In Vivo Glucose[J]. ACS Sensors, 2024, 9(3): 1065-1088.
[31] 高鑫禹, 徐泽楷, 陈力群. 微创及无创血糖检测方法研究现状[J]. 生物医学工程学杂志, 2023, 40(2): 365-372.
[32] 汪颖, 高丽茵, 孙莹莹. 基于可穿戴的葡萄糖电化学传感器研究进展[J/OL]. 中国测试, 2024: 1-13.
[33] Tang L, Chang S J, Chen C J, et al. Non-Invasive Blood Glucose Monitoring Technology: A Review[J]. Sensors, 2020, 20(23): 6925.
[34] Sun Y, Zhao J, Zhang L, et al. Effectiveness and safety of stem cell therapy for diabetic foot: a meta-analysis update[J]. Stem Cell Research & Therapy, 2022, 13(1)：416.
[35] Dayya D, O’Neill O J, Huedo-Medina T B, et al. Debridement of Diabetic Foot Ulcers[J]. Advances in Wound Care, 2022, 11(12): 666-686.
[36] 刘敏, 冉兴无, 陈大伟, 等. 超声水刀在糖尿病慢性难愈性溃疡中的清创效果观察[J]. 华西医学, 2016, 31(1): 100-102.
[37] 常春雷, 戚晓霞, 陈世红, 等. 超声清创联合自溶性清创治疗糖尿病足溃疡的临床研究[J]. 华西医学, 2021, 36(4): 461-464.
[38] Dayya D, O’Neill O J, Huedo-Medina T B, et al. Debridement of Diabetic Foot Ulcers[J]. Advances in Wound Care, 2022, 11(12): 666-686.
[39] 路遥, 杨润功, 朱加亮. 慢性创面清创技术的研究进展[J]. 中国修复重建外科杂志, 2018, 32(8): 1096-1101.
[40] 钟沂岑, 徐国先, 马开兰. 新型敷料在慢性创面治疗中的应用[J]. 现代医药卫生, 2017, 33(16): 2530-2532.
[41] 甘丽莉, 熊娜, 刘燕飞. 水凝胶药物支架修复皮肤创面：临床应用可能性的挑战[J]. 中国组织工程研究, 2021, 25(22): 3578-3583.
[42] 汪涛, 范隆华, 陈斌, 等. 负压吸引技术促进糖尿病足伤口愈合的作用[R]. 复旦大学附属中山医院青浦分院, 2024.
[43] 张海博, 王嘉淼, 张国辉. 糖尿病足溃疡创面形成机制及外科治疗进展[J]. 中国医疗美容, 2024(2): 135-141.
[44] 郭庆, 李冠琳, 李丹, 等. 间充质干细胞治疗糖尿病的研究进展[J]. 医疗装备, 2023(6): 161-164.
[45] Chen H, Yao L, Zhou Y, et al. Evaluation of Antibiotic‐Loaded Bone Cement in Treatment of Infected Diabetic Foot: Systematic Review and Meta‐Analysis[J]. Diabetes/ Metabolism Research and Reviews, 2024, 40(8): e70002.
[46] 张琨, 阿古达木, 宝泉, 等. 抗生素骨水泥治疗糖尿病软组织感染创面研究进展[J]. 实用手外科杂志, 2024, 38(3): 378-381.
[47] Lavery L A. Effectiveness and safety of elective surgical procedures to improve wound healing and reduce re‐ulceration in diabetic patients with foot ulcers[J]. Diabetes/Metabolism Research and Reviews, 2012, 28(S1): 60-63.
[48] 刘井双, 于艳梅. 下肢血管微创介入在缺血型糖尿病足中的应用效果分析[J]. 中国烧伤创疡杂志, 2020(6): 399-402.
[49] 刘杰, 花奇凯, 李山郎, 等. 骨膜牵张技术用于糖尿病足治疗的理论基础及临床结果验证[J]. 中国组织工程研究, 2022, 26(32): 5236-5241.
[50] 郑林洋, 陈开良, 王溶, 等. 骨膜牵张技术治疗糖尿病足创面1例报道并文献复习[J]. 中国临床研究, 2023, 36(8): 1264-1266.
[51] 李抒凝, 谢继鼎, 王颖, 等. 中西医诊治糖尿病足的进展与思考[J]. 临床误诊误治, 2024,13(17): 79-85.
[52] Lim J Z M, Ng N S L, Thomas C. Prevention and treatment of diabetic foot ulcers[J]. Journal of the Royal Society of Medicine, 2017, 110(3):104-109.
[53] Lipsky B A. Diabetic foot infections: current treatment and delaying the “post-antibiotic era”[J]. Diabetes/Metabolism Research and Reviews, 2016, 32(S1): 246-253.
[54] 刘月红. 糖尿病足的管理与治疗[J]. 开卷有益-求医问药, 2022(12): 42-43.