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Diabetes care:抗生素是糖尿病足骨髓炎治疗的**

2014-04-01 desperado-c dxy

目前,尚无前瞻性试验研究在糖尿病足骨髓炎患者中比单用抗生素治疗与外科手术治疗。 为此,来自西班牙马德里康普顿斯大学的Lázaro-Martínez教授及其团队进行了一项研究,对单用抗生素治疗和接受保守手术治疗的糖尿病足骨髓炎患者的治疗结局进行比较,并在治愈后对患者进行12周随访。该研究结果发表在2014年03月的Diabetes care杂志上。【原文下载】 该研究是马德里康普顿斯大学

目前,尚无前瞻性试验研究在糖尿病足骨髓炎患者中比单用抗生素治疗与外科手术治疗。

为此,来自西班牙马德里康普顿斯大学的Lázaro-Martínez教授及其团队进行了一项研究,对单用抗生素治疗和接受保守手术治疗的糖尿病足骨髓炎患者的治疗结局进行比较,并在治愈后对患者进行12周随访。该研究结果发表在2014年03月的Diabetes care杂志上。【原文下载】

该研究是马德里康普顿斯大学糖尿病足中心在2010年01月01日至2012年12月31日期间进行的一项前瞻性随机对照试验,受试者为并发骨髓炎的糖尿病神经性足溃疡患者。研究中,受试者被随机分成两组:抗生素组(AG)和手术组(SG)。AG组受试者接受为期90天的抗生素抗感染治疗;而SG组受试者接受保守手术治疗,并在术后进行10天抗生素抗感染治疗。

该研究中,AG组中有18例患者(75%)达到一期愈合,而SG组中有19例患者(86.3%)达到一期愈合。AG组中位愈合时间为7周,而SG组中位愈合时间为6周。AG组中有4例患者病情加重(16.6),并因此进行手术治疗。SG组中有3例患者接受二次手术治疗。两组间的小截肢率没有明显差异。

该研究提示,在并发骨髓炎、但没有局部缺血或坏死性软组织感染的糖尿病神经性足溃疡患者中,抗生素治疗与手术治疗在愈合率、愈合时间、以及短期并发症方面有相似的治疗效果。

这项研究表明,在临床工作中,其实很多糖尿病足骨髓炎患者无需手术,可首先抗生素抗感染治疗,大部分患者病情可获得改善,少数病情没有改善或进一步加重的患者,可以考虑进行手术治疗。

原始出处:

Lázaro-Martínez JL1, Aragón-Sánchez J, García-Morales E.Antibiotics versus conservative surgery for treating diabetic foot osteomyelitis: a randomized comparative trial.Diabetes Care. 2014 Mar;37(3):789-95. doi: 10.2337/dc13-1526.【原文下载】


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    2015-03-06 智智灵药
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    2014-04-03 宋威

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