Analysis Of Clinical Characteristics And Risk Factors In Patients With Diabetic Foot Amputation

Diabetic foot(DF)is a major public health problem that causes heavy social burden.Numbness,tingling,abnormal sensation of cold and heat,intermittent claudication,ulcer and gangrene are the clinical trails of diabetic foot,which belongs to the category of "Tuoju"and"Jinju" of traditional Chinese medicine.DF is estimated to be the leading cause of nontraumatic amputation.Every 20 seconds,there is one lower limb amputation due to diabetic complications.The total amputation rate of diabetic foot ulcer in China was 19.03%,of which the major amputation rate was 2.14%,and the minor amputation rate was 16.88%.However,according to the existing literature,the amputation rate of diabetic foot ulcer is often underestimated.DF is a serious complication of diabetes,and lower limb amputation is a common and bad consequence of late DF.And major amputation leads to severe disability and seriously reduces the quality of life.Therefore,it is an urgent need for society to find out the clinical characteristics of amputees and to intervene early.OBJECTIVE:To investigate the distribution of syndrome types,clinical characteristics and risk factors for major amputation in patients with diabetic foot.METHOD:From January 2011 to August 2018,patients with diabetic foot ulcer who underwent major amputation in the Peripheral Vascular Department,Dongzhimen Hospital were selected as the research objects.The general situation,complications,clinical characteristics,laboratory examinations and TCM syndromes of patients were collected by the unified scale.Epidata 3.1 software was used for data double entry management and data quality control.SPSS 20.0 statistical software was used for statistical analysis.RESULTS:A total of 93 patients underwent major amputation,including 68 males and 25 females.The average age was(65.29±9.07).Peripheral artery disease(90%),diabetic peripheral neuropathy(86%)and hypertension(83%)were the most common complications.Ischemic heart disease,cerebrovascular disease and dialysis accounted for 77%,61%and 16%respectively.The frequency of TCM syndromes in these patients ranged from high to low were blood stasis(44%),damp-heat toxin accumulation(30%),deficiency of both qi and blood(15%)and deficiency of both qi and Yin(11%).TCM syndromes in patients with large amputation were related to infection IDSA classification and blood perfusion(P<0.05).CONCLUSION:To identify and intervene independent risk factors early is the key to prevent major amputation.Emphasis should be placed on patients with blood stasis and damp-heat and toxin accumulation syndrome.Once diabetic foot ulcer occurs,it is of essential importance to improve blood supply actively,control infection and relieve pain,especially for patients with various and complex complications,ulcer involved bone and heel ulcer.