胫骨横向骨搬移手术治疗糖尿病足效果的影响因素分析

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Abstract Objective To analyze the influencing factors of the curative effect of transverse tibial bone transport on diabetic foot. Methods From January 2017 to December 2019, a total of 80 patients with diabetic foot who underwent tibial lateral bone transport surgery at Xintang Hospital of Zengcheng, Guangzhou City were taken as the research objects, and their clinical data were collected. According to the treatment effect, the patients were divided into 63 cases in the healing group and 17 cases in the unhealed group. The clinical data of the two groups were compared, and multivariate logistic regression was used to analyze the influencing factors of the curative effect of the treatment of diabetic foot. Results In this study, 80 patients with diabetic foot completed the tibial lateral bone transport surgery. The foot skin temperature and ankle-brachial blood pressure index were higher than those of the preoperative one week after the operation, and the visual analogue score was lower than that of the preoperative (P ＜ 0.05). Follow-up showed that the number of ulcers healed was 63 cases. The proportions of under 60 years old, the course of the disease less than 10 years, diabetic nephropathy, the nature of the ulcer was neurogenic, the area of the ulcer less than 5 cm2, single infection, normal dorsal artery pulsation, albumin (Alb)≥35 g/L and hemoglobin (Hb)≥90 g/L of the healing group were greater than those of the unhealed group, and the differences were statistically significant (P ＜ 0.05). The osteotomy area of 10 cm×2 cm, the moving speed of 1.0 mm/d, while the moving time of the 4th day after surgery of healing group were all smaller than those of the unhealed group, and the differences were statistically significant (P ＜ 0.05). Multivariate logistic regression analysis showed that diabetic nephropathy (OR = 2.815, 95%CI: 1.161-6.827), nature of ulcers (OR = 2.694, 95%CI: 1.204-6.029), dorsal artery pulsation (OR = 2.754, 95%CI: 1.202-6.310), Alb (OR = 0.359, 95%CI: 0.161-0.799), Hb (OR = 0.373, 95%CI: 0.172-0.808), osteotomy area (OR = 2.762, 95%CI: 1.196-6.378), moving speed (OR = 2.651, 95%CI: 1.178-5.968) and moving time (OR = 2.740, 95%CI: 1.168-6.428) were the influencing factors of the curative effect of tibia lateral bone transport surgery in the treatment of diabetic foot (P ＜ 0.05). Conclusion Tibia lateral bone transport surgery has good application value in the treatment of diabetic foot, but the curative effect will be affected by diabetic nephropathy, ulcer nature, dorsal artery pulsation, Alb, Hb, osteotomy area, moving speed and moving time.

Key words： Transverse tibial bone transport Diabetic foot Curative effect Influencing factor

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	WU Zhichang1 JIANG Guiyong2 MO Jiehua1

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WU Zhichang1 JIANG Guiyong2 MO Jiehua1. Influencing factors analysis of the curative effect of transverse tibial bone transport on diabetic foot[J]. 中国医药导报, 2021, 18(11): 50-53,65.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I11/50

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