Hyperbaric Oxygen Therapy for Diabetic Foot

糖尿病足的高壓氧治療

吳志隆(Chih-Lung Wu) ； 林榮一(Zong-I Lee) ； 周明智(Ming-Chih Chou)

《中山醫學雜誌》 14卷2期 (2003/05) Pp. 195-200

https://doi.org/10.30096/CSMJ.200305.0002

摘要

近年來台灣由於經濟的成長與飲食文化的改變，糖尿病的盛行率逐漸地增加，再加上醫療科技進步使糖尿病病人壽命延長，於是因為糖尿病引起的慢性併發症-糖尿病足經常可見。傳統治療糖尿病足的方法費時費力，因此就有了許多輔助方法產生，其中高壓氧輔助治療糖尿病足已經在很多報告中被証實有效，但是並非所有的病人皆可治療成功，這篇論文研究的目的是藉由評估糖尿病病人重要的臨床資料，來找出影響高壓氧治療成功與否的預測因子。
從西元1999年7月到2001年10月，總共收集了49位糖尿病足病人，曾接受高壓氧治療。使用統計分析病人的年齡、血糖、周邊血管疾病、白血球指數、細菌感染數目與尿毒症等資料。
49位病人有32位成功，17位失敗。利用邏輯式回歸分析，結果顯示周邊血管疾病是影響治療結果最重要預測因子，其次是白血球指數的升高。
根據本篇研究的結果，糖尿病足在高壓氧治療前應先改善足部血循與控制感染，因此我們建議了一個治療流程表。

關鍵字

糖尿病足 ； 高壓氧輔助治療 ； 周邊血管疾病 ； 白血球指數

並列摘要

The prevalence of diabetes mellitus (DM) has increased in Taiwan recently. Diabetic foot is a chronic complication of DM. In many reports, hyperbaric oxygen therapy (HBOT) has been approved as an effective adjunctive therapy in the management of diabetic foot for some cases. The purpose of this study is an attempt to identify the predictive factors for the successful outcome of HBOT.
From July 1999 to Dec. 2001, we retrospectively collected data on 49 patients with diabetic foot treated with HBOT. There were 19 females and 30 males. We statistically analyzed the clinical data of these patients, including age, fasting blood sugar, peripheral vascular disease, leukocyte count, bacterial count and uremia.
Of the 49 patients, 32 patients were treated successfully with HBOT while 17 patients had unsuccessful result. We used logistic regression to analyze the data and found the most important predictive factor associated with the outcome of HBOT was peripheral vascular disease, the second most important factor was an elevated leukocyte count.
According to this study, we should improve the peripheral circulation and control infection of diabetic foot before HBOT. A treatment protocol is also proposed.

並列關鍵字

diabetic foot ； hyperbaric oxygen therapy ； peripheral vascular disease ； elevated leukocyte count