糖尿病患下肢截肢相關因素之探討

A Study on the Incidence and Associated Factor of Lower Leg Amputation in Type 2 Diabetes Patients

本研究探討第二型糖尿病患足部潰瘍接受下肢截肢的相關因素。樣本來自南部某醫學中心，以病歷回溯方式收集191位30歲以上第2型糖尿病患因足部潰瘍住院的病人，資料收集包括年齡、性別、糖尿病罹病史、糖化血色素、周邊動脈血管疾病、足部神經病變、血壓、血脂和抽菸史等，以SPSS 10.0統計軟體進行資料分析，採用統計方法有卡方檢定和百分比作分析統計。結果發現糖尿病患者接受下肢截肢有61.3％，男性截肢率佔48.7％，女性截肢率佔51.3％。截肢的因素中周邊動脈阻塞合併感染呈顯著差異(P<.001)。由本研究結果得知，下肢截肢主要發生在周邊動脈血管阻塞合併有感染的族群，我們建議積極傷口清創術配合正確適當的抗生素使用和預防性下肢血管繞道術可能對截肢發生率有正面改善之影響，並為足部照護防治衛教之參考。

This study investigated factors associated with lower leg amputation among type 2 diabetic patients with serious leg ulcers. The sample was taken from a major teaching hospital in southern Taiwan. A total of 191 patients above the age of 30 were included in the study. Data being collected included age, gender, diabetes history, HbA1C, peripheral vascular disease (PVD), blood pressure, lipids, and smoking history. Data were analyzed using SPSS 10.0 and statistical methods included descriptive statistics and Chi-square test. Of the 61.3% patients who received an amputation, 48.7% were male and 51.3% were female. Amputation was significantly associated with infection and PVD (P< .001). The finding suggested that cleaning wound using antibiotics and preventative by-pass surgery for PVD could be beneficial to diabetes foot care.