摘要
本研究收集自民國67年元月至76年12月間因糖尿病足而施行截肢手術的住院病患共97位，以資料分析，問卷調查及電話追蹤方式，探討影響傷口癒合的種種因素。 結果發現截足部位以膝下截肢最多，共55位(56.7%)，最少為膝部截肢1位(1.0%)。截肢部位與術前評估測驗所建議不盡配合。術後傷口癒合非常良好者僅佔13位(13.4%)，癒合良好17位(17.5%)，而癒合不良則高達56位(56.7%) ，更有11位因併發症死亡。 傷口癒合與各組年齡、手術前血紅素值、血球比容、及白蛋白值均無顯著關係，但卻與術前是否有傷口感染及術後血糖濃度控制情況有密切關係。傷口細菌培養顯示多為混合感染，菌種以Enterococcus最多。 本研究個案中只有7位有長期規則用藥控制血糖，顯示國人在糖尿病認識、治療及合併症之預防上仍有待加強。
關鍵字
無資料並列摘要
The foot of the diabetic is most susceptible to the diabetic complications of neuropathy and angiopathy. In such condition, any trauma may quickly lead to ulceration, infection, gangrene and finally, amputation. It is hard to make a decision to the level of amputation due to hostile, and uncoop erative of patient and family, so, postoperative wound healing are different in many cases. This study is a retrospective study, 97 cases due to diabetic ,ammputation who admitted to Chang Gung Memorial Hospital from January, 1978 to December, 1987, were followed up by questionnares and telephone. The patients comprised of 59 males and 38 females, ranging of age from 35 to 87 years with mean age of 62.5±9.8 years. 55 patients (56.7%) received below-knee amputation, 22 (22.7%) received above-knee amputatuin, 16(16.5%) received toe amputation, 3(3.1%) received Syme amputation, and only one received knee disarticulation. After operation only 13 cases (13.4%) had primary wound healing, 17(17.5%) showed fair healing, 56(56.7%) were poor. Unfortunately, 11(11.4%) died in hospital due to complication. In our study, wound healing was not correlates with age, hemoglobin, hematocrit, or albumin level, but strong correlated with blood sugar control after operation. Most of the wound culture showed mixed flora infedtion, average 2.5± 1.1 isolates were obtained. Enterococcus was the most common etiologic agents. Most of the patients in this study had known diabetes mellitus history, only 7 had regular sugar control, 3 of them knew diabetec mellitus after they got leg ulcer. So, education to diabetic control, prevention and recognization of complication is still very important.