糖尿病足病变诊断与治疗的临床思考

:1005-2194(2005)04-0375-03:306(,100101)E2mail:[e-mail]:R5:A,306,,,2,,,(),,,,,,47%,[1,2],2%,8%12%[3],[4],,,,1,,Wagner1[5]1Wagner0,1,2,,3,4()5:,,,(,charcot),,,,3,,,,TEXAS[6]2,,,,11,902TEXAS1A2B3C4DFoster57320054254©1995-2005TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.12,22,32,42,523512,35:3,;4,;5,[7],,,,:()(charcot)2,,,,,,22,,,,,,[8]10g10g,,,,,,,[9]Biothesi2ometerBiothesiometer,,,,,,,infra2reddermalthermometry,,,[10],,,,MatscanFoot2scan,[11],[2],(),46752,1164,2419%2(ABI),110114,017019,015017,015(),,(200mmHg,1mmHg=01133kPa)ABI114,,,,,,2802ABI01960,21143%ABI,,[12](TcPO2),,40mmHgTcPO230mmHg,,TcPO220mmHg,,100%,TcPO210mmHg,(),,,X,X,111In,3,67320054254©1995-2005TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.,,2,;,(macera2tion),,,,Dermagraft,,[13],,,,,,,,65422;E1,,20min,(:)E1,,,321428d,,,,,LDL2,,,,BommayyaEdmonds30(),230,262810[14],,,,,,,,,,,,,,,,,1,..:..:,2003.6292BoultonAJM.Thediabeticfoot:fromarttoscience.Diabetologia,2004,47(8):1342213533,,..,2003,2(4):27122744..,2004,12(5):3095BoultonAJM.Footproblemsinpatientswithdiabetesmellitus.In:PickupJ,WilliamsG.TextbookofDiabetes.2ndedu.London:Black2well,1997.12206ArmstrongDG,LaveryLA,HarklessLB.Validationofadiabeticwoundclassificationsystem2thecontributionofdepth,infection,andischemiatoriskofamputation.DiabetesCare,1998,21(5):85528597FosterAVM,EdmondsME.Thesimplestagingsystem2anewdiabet2icfootclassificationvalidatedtoguidetherapy.In:NeurodiabandDFSGofEASDJointMeeting(AbstrctsBook)Hungary,2002.1128AmericanDiabetesAssociation.ConsensusdevelopmentconferenceondiabeticfootWoundCare.DiabetesCare,1999,22(9):1354213609McGillM,MolyneauzL,YueDK.UseoftheSemmesWeinstein5.07/10gmmonofilament:thelongandtheshortofit.DiabeticMedi2cine,1998,15(7):615261710ArmstrongDG.Infra2reddermalthermometry:astethoscopeforthediabeticfoot?ForumonWoundCare,1998,Specialedition:1511BarnettS.Gaitanalysis:partofthefirstNationalUnifiedPediatryConference.DiabeticFoot,1998,1(1):7227412,,,..,2004,12(5):324232713McColganM,FosterA,EdmondsM.Dermagraftinthetreatmentofdiabeticfootulcers.DiabeticFoot,1998,1(1):7527814BommayyaI,EdmondsM.Theimportanceofinfra2inguinalangio2plastyinsalvageofdiabeticfeet.In:NeurodiabandDFSGofEASDJointMeeting(AbstrctsBook)Hungary,2002.130(2005-02-11)77320054254©1995-2005TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.