切换至 "中华医学电子期刊资源库"

中华损伤与修复杂志(电子版) ›› 2022, Vol. 17 ›› Issue (04) : 349 -353. doi: 10.3877/cma.j.issn.1673-9450.2022.04.011

综述·糖尿病与糖尿病足的防治

糖尿病足的诊断及治疗进展
刘慧真1, 李恭驰2, 杜烨1, 王卉1, 李炳辉1,()   
  1. 1. 430077 武汉,华中科技大学同济医学院附属梨园医院创面修复中心,湖北省慢性创面及糖尿病足医学临床研究中心
    2. 430022 武汉,华中科技大学同济医学院附属协和医院手外科
  • 收稿日期:2022-04-21 出版日期:2022-08-01
  • 通信作者: 李炳辉
  • 基金资助:
    国家自然科学基金青年科学基金项目(81801922); 湖北省自然科学基金面上项目(2020CFB696); 湖北省科技创新平台专项资助建设项目(2018BCC340); 国家重大疾病多学科合作诊疗能力建设项目(国卫办医函[2019]542号); 湖北省重点研发计划项目(2020BCB029)

Diagnosis and treatment progress of diabetic foot

Huizhen Liu1, Gongchi Li2, Ye Du1, Hui Wang1, Binghui Li1,()   

  1. 1. Wound Repair Center of Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology, Hubei Provincial Clinical Research Center of Chronic Wound and Diabetic Foot Medicine, Wuhan 430077, China
    2. Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  • Received:2022-04-21 Published:2022-08-01
  • Corresponding author: Binghui Li
引用本文:

刘慧真, 李恭驰, 杜烨, 王卉, 李炳辉. 糖尿病足的诊断及治疗进展[J/OL]. 中华损伤与修复杂志(电子版), 2022, 17(04): 349-353.

Huizhen Liu, Gongchi Li, Ye Du, Hui Wang, Binghui Li. Diagnosis and treatment progress of diabetic foot[J/OL]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2022, 17(04): 349-353.

糖尿病足是糖尿病的严重并发症,发病率逐年增高,也是导致患者截肢主要原因。糖尿病足的发病机制复杂,临床表现多变,且治疗难度大、时间长、费用高,给患者造成了心理和经济方面的巨大负担。近年来对于糖尿病足的研究不断发展,提出了一些新的诊断策略和治疗方法。本文对糖尿病足的相关定义、分类、发病机制、诊断及治疗进展作一综述,并对糖尿病足未来的诊治模式进行展望。

Diabetic foot is a serious complication of diabetes, and incidence rate is increasing year by year, which is the main reason leading to amputation. The pathogenesis of diabetic foot is complex and the clinical manifestations are changeable. The treatment of diabetes foot is difficult, long time and high cost, causing a huge psychological and economic burden to patients. In recent years, the research on diabetic foot has been developing, and some new diagnostic strategies and therapies have been put forward. This paper reviews the related definition, classification, pathogenesis, diagnosis and treatment progress of diabetic foot, and prospects the future diagnosis and treatment mode of diabetic foot.

[1]
Wang D, Ouyang J, Zhou P, et al. A Novel Low-Cost Wireless Footwear System for Monitoring Diabetic Foot Patients[J]. IEEE Trans Biomed Circuits Syst, 2021, 15(1): 43-54.
[2]
Abbas ZG, Boulton AJM. Diabetic foot ulcer disease in African continent: 'From clinical care to implementation’- Review of diabetic foot in last 60 years - 1960 to 2020[J]. Diabetes Res Clin Pract, 2022, 183: 109155.
[3]
Zhang P, Lu J, Jing Y, et al. Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis (dagger)[J]. Ann Med, 2017, 49(2): 106-116.
[4]
Fu XL, Ding H, Miao WW, et al. Global recurrence rates in diabetic foot ulcers: A systematic review and meta-analysis[J]. Diabetes Metab Res Rev, 2019, 35(6): e3160.
[5]
郭光华,朱峰,闵定宏,等. 糖尿病足合并难愈性创面外科治疗全国专家共识(2020版)[J/CD]. 中华损伤与修复杂志(电子版), 2020, 15(4): 256-263.
[6]
Mader JK, Haas W, Aberer F, et al. Patients with healed diabetic foot ulcer represent a cohort at highest risk for future fatal events[J]. Sci Rep, 2019, 9(1): 10325.
[7]
Vadiveloo T, Jeffcoate W, Donnan PT, et al. Amputation-free survival in 17,353 people at high risk for foot ulceration in diabetes: a national observational study[J]. Diabetologia, 2018, 61(12): 2590-2597.
[8]
李炳辉,籍胤玺. 糖尿病足创面的治疗策略[J/CD]. 中华损伤与修复杂志(电子版), 2009, 4(4): 375-383.
[9]
Jiang Y, Ran X, Jia L, et al. Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China[J]. Int J Low Extrem Wounds, 2015, 14(1): 19-27.
[10]
Yamagishi S, Imaizumi T. Diabetic vascular complications: pathophysiology, biochemical basis and potential therapeutic strategy[J]. Curr Pharm Des, 2005, 11(18): 2279-2299.
[11]
李炳辉,陈洪平. 糖尿病足创面局部处理[J/CD]. 中华损伤与修复杂志(电子版), 2011, 6(4): 516-521.
[12]
Spiliopoulos S, Festas G, Paraskevopoulos I, et al. Overcoming ischemia in the diabetic foot: Minimally invasive treatment options[J]. World J Diabetes, 2021, 12(12): 2011-2026.
[13]
Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association[J]. Diabetes Care, 2017, 40(1): 136-154.
[14]
Feldman EL, Nave KA, Jensen TS, et al. New Horizons in Diabetic Neuropathy: Mechanisms, Bioenergetics, and Pain[J]. Neuron, 2017, 93(6): 1296-1313.
[15]
Sajic M. Mitochondrial dynamics in peripheral neuropathies[J]. Antioxid Redox Signal, 2014, 21(4): 601-620.
[16]
武钰翔,姜玉峰,王爱红,等. 糖尿病足局部抗感染治疗的研究进展[J]. 临床荟萃2018, 33(2): 100-102, 110.
[17]
Pitocco D, Spanu T, Di Leo M, et al. Diabetic foot infections: a comprehensive overview[J]. Eur Rev Med Pharmacol Sci, 2019, 23(2 Suppl): 26-37.
[18]
Shettigar K, Murali TS. Virulence factors and clonal diversity of Staphylococcus aureus in colonization and wound infection with emphasis on diabetic foot infection[J]. Eur J Clin Microbiol Infect Dis, 2020, 39(12): 2235-2246.
[19]
Macdonald KE, Boeckh S, Stacey HJ, et al. The microbiology of diabetic foot infections: a meta-analysis[J]. BMC Infect Dis, 2021, 21(1): 770.
[20]
Ndosi M, Wright-Hughes A, Brown S, et al. Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study[J]. Diabet Med, 2018, 35(1): 78-88.
[21]
Vriens B, D′Abate F, Ozdemir BA, et al. Clinical examination and non-invasive screening tests in the diagnosis of peripheral artery disease in people with diabetes-related foot ulceration[J]. Diabet Med, 2018, 35(7): 895-902.
[22]
Forsythe RO, Apelqvist J, Boyko EJ, et al. Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: A systematic review[J]. Diabetes Metab Res Rev, 2020, 36 Suppl 1: e3277.
[23]
Williams DT, Harding KG, Price P. An evaluation of the efficacy of methods used in screening for lower-limb arterial disease in diabetes[J]. Diabetes Care, 2005, 28(9): 2206-2210.
[24]
Zilliox LA. Diabetes and Peripheral Nerve Disease[J]. Clin Geriatr Med, 2021, 37(2): 253-267.
[25]
Wang A, Lv G, Cheng X, et al. Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)[J]. Burns Trauma, 2020, 8: tkaa017.
[26]
Peters EJ, Lipsky BA. Diagnosis and management of infection in the diabetic foot[J]. Med Clin North Am, 2013, 97(5): 911-946.
[27]
Park JH, Suh DH, Kim HJ, et al. Role of procalcitonin in infected diabetic foot ulcer[J]. Diabetes Res Clin Pract, 2017, 128: 51-57.
[28]
Aragón-Sánchez J, Lipsky BA. Modern management of diabetic foot osteomyelitis. The when, how and why of conservative approaches[J]. Expert Rev Anti Infect Ther, 2018, 16(1): 35-50.
[29]
Rastogi A, Mukhopadhyay S, Sahoo JP, et al. Intensive Glycemic Control for Diabetic Foot Ulcer Healing: A Multicentric, Randomized, Parallel Arm, Single-Blind, Controlled Study Protocol (INGLOBE Study)[J]. Int J Low Extrem Wounds, 2020: 1534734620952245.
[30]
冯颖,祝红娟,王倩,等. 糖尿病足患者血糖管理的研究进展[J/CD]. 中华损伤与修复杂志(电子版), 2021, 16(5): 445-448.
[31]
Yadav C, Srikantiah RM, Manjrekar P, et al. Assessment of Mineral Pathophysiology in Patients with Diabetic Foot Ulcer[J]. Biol Trace Elem Res, 2020, 195(2): 366-372.
[32]
Choke E, Tang TY, Cheng SC, et al. Treatment of lower limb ischaemia in patients with diabetes[J]. Diabetes Metab Res Rev, 2020, 36 Suppl 1: e3262.
[33]
徐俊,许樟荣. 国际糖尿病足工作组《糖尿病足溃疡周围动脉病变诊断、预后与管理指南(2019版)》解读[J]. 国际内分泌代谢杂志2021, 41(2): 142-144.
[34]
Schaper NC, van Netten JJ, Apelqvist J, et al. Practical Guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update)[J]. Diabetes Metab Res Rev, 2020, 36 Suppl 1: e3266.
[35]
Nativel M, Potier L, Alexandre L, et al. Lower extremity arterial disease in patients with diabetes: a contemporary narrative review[J]. Cardiovasc Diabetol, 2018, 17(1): 138.
[36]
Farah S, Yammine K. A systematic review on the efficacy of vitamin B supplementation on diabetic peripheral neuropathy[J]. Nutr Rev, 2022, 80(5): 1340-1355.
[37]
Stein J, Geisel J, Obeid R. Association between neuropathy and B-vitamins: A systematic review and meta-analysis[J]. Eur J Neurol, 2021, 28(6): 2054-2064.
[38]
Sloan G, Selvarajah D, Tesfaye S. Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy[J]. Nat Rev Endocrinol, 2021, 17(7): 400-420.
[39]
Lazzarini PA, Jarl G, Gooday C, et al. Effectiveness of offloading interventions to heal foot ulcers in persons with diabetes: a systematic review[J]. Diabetes Metab Res Rev, 2020, 36 Suppl 1(Suppl 1): e3275.
[40]
Quinton TR, Lazzarini PA, Boyle FM, et al. How do Australian podiatrists manage patients with diabetes? The Australian diabetic foot management survey[J]. J Foot Ankle Res, 2015, 8: 16.
[41]
Raspovic A, Landorf KB. A survey of offloading practices for diabetes-related plantar neuropathic foot ulcers[J]. J Foot Ankle Res, 2014, 7: 35.
[42]
Morona JK, Buckley ES, Jones S, et al. Comparison of the clinical effectiveness of different off-loading devices for the treatment of neuropathic foot ulcers in patients with diabetes: a systematic review and meta-analysis[J]. Diabetes Metab Res Rev, 2013, 29(3): 183-193.
[43]
Rinkel WD, Franks B, Birnie E, et al. Cost-Effectiveness of Lower Extremity Nerve Decompression Surgery in the Prevention of Ulcers and Amputations: A Markov Analysis[J]. Plast Reconstr Surg, 2021, 148(5): 1135-1145.
[44]
Dallimore SM, Kaminski MR. Tendon lengthening and fascia release for healing and preventing diabetic foot ulcers: a systematic review and meta-analysis[J]. J Foot Ankle Res, 2015, 8: 33.
[45]
Kalantar Motamedi A, Ansari M. Comparison of Metatarsal Head Resection Versus Conservative Care in Treatment of Neuropathic Diabetic Foot Ulcers[J]. J Foot Ankle Surg, 2017, 56(3): 428-433.
[46]
Armstrong DG, Fiorito JL, Leykum BJ, et al. Clinical efficacy of the pan metatarsal head resection as a curative procedure in patients with diabetes mellitus and neuropathic forefoot wounds[J]. Foot Ankle Spec, 2012, 5(4): 235-240.
[47]
Everett E, Mathioudakis N. Update on management of diabetic foot ulcers[J]. Ann N Y Acad Sci, 2018, 1411(1): 153-165.
[48]
Lipsky BA, Berendt AR, Cornia PB, et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections[J]. Clin Infect Dis, 2012, 54(12): e132-e173.
[49]
De Francesco F, Graziano A, Trovato L, et al. A Regenerative Approach with Dermal Micrografts in the Treatment of Chronic Ulcers[J]. Stem Cell Rev Rep, 2017, 13(1): 139-148.
[50]
王知,李恭驰,李炳辉,等. 猪脱细胞真皮基质促进皮肤细胞迁移修复小鼠创面的研究[J]. 中华实验外科杂志2020, 37(7): 1230-1233.
[51]
Suthar M, Gupta S, Bukhari S, et al. Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series[J]. J Biomed Sci, 2017, 24(1): 16.
[52]
陈诺,李羽霖,阮琼芳,等. 浓缩生长因子及其在促进损伤组织修复中的应用进展[J/CD]. 中华损伤与修复杂志(电子版), 2021, 16(6): 520-524.
[53]
王爱红,许樟荣. 全面系统评估——确保糖尿病足溃疡科学规范诊治的基础[J]. 华西医学2021, 36(4): 432-435.
[54]
Paisey RB, Abbott A, Paisey CF, et al. Diabetic foot ulcer incidence and survival with improved diabetic foot services: an 18-year study[J]. Diabet Med, 2019, 36(11): 1424-1430.
[55]
陈明卫,许樟荣. 糖尿病足病:时代在改变[J]. 中华糖尿病杂志2020, 12(6): 359-363.
[1] 农云洁, 黄小桂, 黄裕兰, 农恒荣. 超声在多重肺部感染诊断中的临床应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(09): 872-876.
[2] 王杰, 袁泉, 王玥琦, 乔佳君, 谭春丽, 夏仲元, 刘守尧. 溃疡油在糖尿病足溃疡治疗中的应用效果及安全性观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 480-484.
[3] 周涵, 武胡雯, 张培深, 邓晗彬, 范闻轩, 李嘉诚, 程少文. 蛋白质组学在慢性难愈合创面研究中的应用进展[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 536-540.
[4] 姜珊, 李湘燕, 田硕涵, 温冰, 何睿, 齐心. 采用优化抗感染治疗模式改善糖尿病足感染预后的临床观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(05): 398-403.
[5] 许月芳, 刘旺, 曾妙甜, 郭宇姝. 多粘菌素B和多粘菌素E治疗外科多重耐药菌感染临床疗效及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 700-703.
[6] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[7] 皮尔地瓦斯·麦麦提玉素甫, 李慧灵, 艾克拜尔·艾力, 李赞林, 王志, 克力木·阿不都热依木. 生物补片修补巨大复发性腹壁切口疝临床疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 624-628.
[8] 顾熙, 徐子宇, 周澍, 张吴楼, 张业鹏, 林昊, 刘宗航, 嵇振岭, 郑立锋. 腹股沟疝腹膜前间隙无张力修补术后补片感染10 例报道[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 665-669.
[9] 臧宇, 姚胜, 朱新勇, 戎世捧, 田智超. 低温等离子射频消融治疗腹壁疝术后补片感染的临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 687-692.
[10] 杨闯, 马雪. 腹壁疝术后感染的危险因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 693-696.
[11] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[12] 董晓斌, 张静, 苏莎莎, 莎比亚·沙吾提, 盛好. 溃疡性结肠炎患者相关环状RNA 差异表达谱分析及功能研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 499-509.
[13] 陈利, 杨长青, 朱风尚. 重视炎症性肠病和代谢相关脂肪性肝病间的串话机制研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 385-389.
[14] 贾玲玲, 滕飞, 常键, 黄福, 刘剑萍. 心肺康复在各种疾病中应用的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 859-862.
[15] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?