活動力正常的老年糖尿病患者罕見之三期壓瘡－個案報告

A Stage 3 Pressure Ulcer of an Ambulatory Geriatric Diabetic Patient: Case Report

張安華(An-Hua Jhang) ； 溫瓊容(Chiung-Jung Wen)

《台灣老年醫學暨老年學會雜誌》 14卷3期 (2019/08) Pp. 180-190

https://doi.org/10.29461/TGGa.201908_14(3).0005

摘要

本個案為71歲生活自理的獨居女性，因持續數日的身體異味及全身疲倦自行步行前來就醫，最後發現係因一個尾骶骨第三期的壓傷感染所致。糖尿病盛行率在老年患者當中較一般成人高，長期控制不良的血糖會導致大血管及小血管的病變，小血管的病變包含糖尿病視網膜病變、糖尿病腎病變、以及糖尿病神經病變，血管的病變會導致末梢循環不佳，而老化的皮膚變薄且缺乏皮脂分泌，容易乾裂而產生傷口，因故皮膚傷口不易癒合且容易感染，但患者往往不容易在第一時間發現。多項糖尿病併發症為壓傷風險因子。糖尿病皮膚併發症在老年患者相當常見，本文提供臨床工作者一個以非特異性症狀為主訴，意識清楚且可自由行動的糖尿病患者，罕見之深度壓傷傷口的病例作參考，以期能早期發現早期治療。

關鍵字

老年人 ； 糖尿病 ； 壓傷

並列摘要

A 71-year-old female, living alone, with atypical initial presentation as body odor and general malaise for several days, was admitted to our ward due to a stage III sacral pressure injury infection. Diabetes mellitus is more prevalent in the elderly than in the general adult population. Poor blood sugar control can lead to macrovascular and microvascular complications of diabetes. Microvascular complications such as diabetic retinopathy, nephropathy, and neuropathy in turn can cause the development of poor circulation of peripheral sites. In addition, aging also plays a role in thinning and drying of the skin, thereby making the skin vulnerable to infection. It is hard for elderly diabetic patients to notice skin complications. Multiple diabetic complications are a risk factor of pressure injury. Diabetic skin complications are common in the geriatric population. In the report, a case of a patient with pressure ulcer was presented for the future reference of clinicians to promote early detection and treatment of diabetic skin complications.

並列關鍵字

elderly ； diabetic mellitus ； pressure injury