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糖尿病足溃疡治疗的进展.pdf

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460()200944ChinJInjuryRepairandWoundHealing(ElectronicEdition),August2009,Vol4,No.4 Wagner 501 2 345 [1] 1999 [2] LeMasterReiber[3]1964120054 15%85% [4] [5-6] [5]3 [7] 8%[8]50% 15[9] 25%[10] 2 117000 Emailsun-yiqun@163.com ()200944ChinJInjuryRepairandWoundHealing(ElectronicEdition),August2009,Vol4,No.4461 [7] [11] 1. 2 [12-13] E1 2. MadiganArmyMedicalCenter [14] 1 2/3[15]Grayson[16] 2 [17] 2 [18] 462()200944ChinJInjuryRepairandWoundHealing(ElectronicEdition),August2009,Vol4,No.4 3 [19] [18] 222225~49d 1344~112d [18] 4 [15] Jude[20] [21] CTCTA [22] [23] [21] [22] ()200944ChinJInjuryRepairandWoundHealing(ElectronicEdition),August2009,Vol4,No.4463 5 Atindas[24]38 3Tosun[25]37 4 [22] [22] 6 [22] B CT [22] 7 70%~90%[26][27] Charcot [28-29] 464()200944ChinJInjuryRepairandWoundHealing(ElectronicEdition),August2009,Vol4,No.4 Marrigje[30]98 8 [31-33] [34] [35] 2002 [36] 94102 105 108[37] 2003 [38][39] 100 83.6%91.7%75.0%39.8% 89.2% 29.4%[40]42 [41][40] 3542 ()200944ChinJInjuryRepairandWoundHealing(ElectronicEdition),August2009,Vol4,No.4465 1WagnerFWJr.Thedysvascularfoot:asystemfordiagnosisandtreatment[J].FootAnkle,1981,2(2):64-122. 2ApelqvistJ,BakkerK,vanHoutumWH,etal.Internationalconsensusandpracticalguidelinesonthe managementandthepreventionofthediabeticfoot[J].InternationalWorkingGroupontheDiabetic Foot.DiabetesMetabResRev,2000,16(Suppl1):S84-S92. 3LeMasterJW,ReiberGE.Epidemiologyandeconomicimpactoffootulcers[M].In:BoultonAJM,Cavanagh PR,RaymanG.Thefootindiabetes.4thed.Chichester:JohnWileySons,2006:1-16. 4ViswanathanV,MadhavanS,GnanasundaramS,etal.Effectivenessofdifferenttypesoffootwearinsolesforthe diabeticneuropathicfoot:afollowstudy[J].DiabetesCare,2004,27(2):474-477. 5,.[M].:..: ,20036-9. 6BoultonAJ.Thediabeticfoot:fromarttoscience[J].Diabetologia,2004,47(8):1343-1353. 7,.[J].,2007,36(4):22-25. 8RobertGFrykberg.:[J].: ,2004,24(5):48-55. 9KumarS,AsheHA,ParnellLN,etal.Thepre