2型糖尿病合并周围神经病变患者动静态足底压力分析及减压治疗效果评估
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摘要
目的探究2型糖尿病合并周围神经病变患者动静态足底压力分析及减压治疗效果。方法选取2016年11月～2017年3月期间我科门诊就诊或住院的50例2型糖尿病合并周围神经病变患者作为研究对象,随机分为研究组和对照组各25例,研究组给予减轻足底压力个性化方案治疗,对照组给予常规治疗,不给予个性化方案治疗,对比两组治疗前后足底压力变化、足溃疡发生率等情况。结果静态和动态足底压力较大的分区均为双足M2～4、HM、HL以及右足M5。治疗后,研究组患者左右足M1、M2～4、M5、HL等区域足底压力较治疗前明显减少,差异有统计学意义(P <0.05);而对照组患者左右足M1、M2～4、M5、HL等区域足底压力较治疗前明显增加,差异有统计学意义(P <0.05);两组T1、T2～5、MF、HM等区域足底压力较治疗前对比差异均无统计学意义(P> 0.05)。研究组足溃疡发生率为4.00%(1/25),对照组为24.00%(6/25),两组对比差异有统计学意义(P <0.05)。结论 2型糖尿病合并周围神经病变患者足底压力主要集中在双足M2～4、HM、HL以及右足M5,经给予减轻足底压力个体化方法治疗后,能够有效改善足底压力,降低足溃疡发生率,具有较高的临床价值。
Objective To explore the analysis of dynamic and static plantar pressure in patients with type 2 diabetes mellitus complicated with peripheral neuropathy and the effect of decompression treatment. Methods 50 patients with type 2 diabetes mellitus complicated with peripheral neuropathy who were treated in clinic or hospitalized in our hospital from November 2016 to March 2017 were selected as research objects.They were randomly divided into the study group and the control group,with 25 cases in each group.The study group was given individualized treatment scheme to reduce plantar pressure while the control group was given routine treatment,but not individualized treatment.Changes of plantar pressure and the incidence of foot ulcers before and after the treatment were compared between two groups. Results Static and dynamic areas with greater plantar pressure were found to be bipedal M2-4,HM,HL and right foot M5.After treatment,the plantar pressure of M1,M2-4,M5 and HL of the left and right foot in the study group was significantly lower than that before the treatment,and the difference was statistically significant(P < 0.05).After treatment,the plantar pressure of M1,M2-4,M5 and HL of the left and right foot in the control group was significantly higher than that before the treatment,and the difference was statistically significant(P < 0.05).While the difference in plantar pressure of T1,T2-5,MF and HM area before and after treatment in two groups had no statistical significance(P > 0.05).The incidence of foot ulcers in the study group was 4%(1/25),while that in the control group was 24%(6/25).The difference between the two groups was statistically significant(P < 0.05). Conclusion In patients with type 2 diabetes mellitus patients with peripheral neuropathy,plantar pressure is mainly concentrated in bipedal M2-4,HM,NL and right foot M5.After individualized treatment to relieve plantar pressure,plantar pressure can be effectively improved and the incidence of foot ulcers can be reduced.It has high clinical value.
Objective To explore the analysis of dynamic and static plantar pressure in patients with type 2 diabetes mellitus complicated with peripheral neuropathy and the effect of decompression treatment. Methods 50 patients with type 2 diabetes mellitus complicated with peripheral neuropathy who were treated in clinic or hospitalized in our hospital from November 2016 to March 2017 were selected as research objects.They were randomly divided into the study group and the control group,with 25 cases in each group.The study group was given individualized treatment scheme to reduce plantar pressure while the control group was given routine treatment,but not individualized treatment.Changes of plantar pressure and the incidence of foot ulcers before and after the treatment were compared between two groups. Results Static and dynamic areas with greater plantar pressure were found to be bipedal M2-4,HM,HL and right foot M5.After treatment,the plantar pressure of M1,M2-4,M5 and HL of the left and right foot in the study group was significantly lower than that before the treatment,and the difference was statistically significant(P < 0.05).After treatment,the plantar pressure of M1,M2-4,M5 and HL of the left and right foot in the control group was significantly higher than that before the treatment,and the difference was statistically significant(P < 0.05).While the difference in plantar pressure of T1,T2-5,MF and HM area before and after treatment in two groups had no statistical significance(P > 0.05).The incidence of foot ulcers in the study group was 4%(1/25),while that in the control group was 24%(6/25).The difference between the two groups was statistically significant(P < 0.05). Conclusion In patients with type 2 diabetes mellitus patients with peripheral neuropathy,plantar pressure is mainly concentrated in bipedal M2-4,HM,NL and right foot M5.After individualized treatment to relieve plantar pressure,plantar pressure can be effectively improved and the incidence of foot ulcers can be reduced.It has high clinical value.
引文
[1]Barn R,Waaijman R,Nollet F,et al.Predictors of barefoot plantar pressure during walking in patients with diabetes,peripheral neuropathy and a history of ulceration[J].Plos One,2015,10(2):e0117443.
[2]王红,贾丽萍,刘潇.2型糖尿病患者足底压力变化与周围神经病变的相关性[J].医学临床研究,2016,33(4):789-790.
[3]魏薇,王中京,周玲,等.2型糖尿病周围神经病变的危险因素分析[J].海南医学,2017,28(20):3379-3381.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-40.
[5]丁维,王佳佳,陆祖谦,等.不同Wagner分级糖尿病足患者肾损害的临床研究[J].中华老年多器官疾病杂志,2015,14(5):362-366.
[6]杨晓玲.足底压力改变与2型糖尿病患者周围神经病变病情关系的研究[J].临床和实验医学杂志,2015,8(4):259-263.
[7]符霞军,谢翠华,蒋娅,等.糖尿病足底压力异常患者减压治疗效果分析[J].护理学杂志,2014,29(5):14-16.
[8]蒋娅,李亚洁,谢翠华,等.2型糖尿病病人足底压力影响因素研究[J].护理研究,2013,27(35):4004-4006.
[9]王坤,吕肖锋,焦秀敏,等.糖尿病不同程度周围神经病变患者足底压力变化分析[J].中国全科医学,2014,6(22):2607-2611.
[10]李文霞,罗祥蓉,曹瑛,等.糖尿病周围神经病变患者足底压力与步态的变化[J].广东医学,2017,38(6):859-863.
[11]和瑞婷,葛飞,向沙,等.伴足溃疡病史的糖尿病周围神经病变患者足底压力分布特点分析[J].中国糖尿病杂志,2016,8(7):401-404.
[12]谢翠华,张倩,符霞军,等.糖尿病病人足底压力峰值与糖尿病足底压力性溃疡发生的相关性研究[J].护理研究,2016,7(8):918-921.
[13]Lavery LA,Armstrong DG,Wunderlich RP,et al.Predictive Value of Foot Pressure Assessment As Part of a Population-Based Diabetes Disease Management Program[J].Diabetes Care,2003,26(4):1069-1073.
[14]陈秋香,王方华,王翠芳,等.2型糖尿病并发周围神经病变患者应用中药足浴联合足部护理的效果观察[J].实用临床医药杂志,2017,21(14):55-57.
[15]何红,许亚红,徐国丽,等.“足底操”对0级糖尿病足患者周围神经病变及足底压力的影响[J].现代临床护理,2017,5(2):51-56.
[2]王红,贾丽萍,刘潇.2型糖尿病患者足底压力变化与周围神经病变的相关性[J].医学临床研究,2016,33(4):789-790.
[3]魏薇,王中京,周玲,等.2型糖尿病周围神经病变的危险因素分析[J].海南医学,2017,28(20):3379-3381.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-40.
[5]丁维,王佳佳,陆祖谦,等.不同Wagner分级糖尿病足患者肾损害的临床研究[J].中华老年多器官疾病杂志,2015,14(5):362-366.
[6]杨晓玲.足底压力改变与2型糖尿病患者周围神经病变病情关系的研究[J].临床和实验医学杂志,2015,8(4):259-263.
[7]符霞军,谢翠华,蒋娅,等.糖尿病足底压力异常患者减压治疗效果分析[J].护理学杂志,2014,29(5):14-16.
[8]蒋娅,李亚洁,谢翠华,等.2型糖尿病病人足底压力影响因素研究[J].护理研究,2013,27(35):4004-4006.
[9]王坤,吕肖锋,焦秀敏,等.糖尿病不同程度周围神经病变患者足底压力变化分析[J].中国全科医学,2014,6(22):2607-2611.
[10]李文霞,罗祥蓉,曹瑛,等.糖尿病周围神经病变患者足底压力与步态的变化[J].广东医学,2017,38(6):859-863.
[11]和瑞婷,葛飞,向沙,等.伴足溃疡病史的糖尿病周围神经病变患者足底压力分布特点分析[J].中国糖尿病杂志,2016,8(7):401-404.
[12]谢翠华,张倩,符霞军,等.糖尿病病人足底压力峰值与糖尿病足底压力性溃疡发生的相关性研究[J].护理研究,2016,7(8):918-921.
[13]Lavery LA,Armstrong DG,Wunderlich RP,et al.Predictive Value of Foot Pressure Assessment As Part of a Population-Based Diabetes Disease Management Program[J].Diabetes Care,2003,26(4):1069-1073.
[14]陈秋香,王方华,王翠芳,等.2型糖尿病并发周围神经病变患者应用中药足浴联合足部护理的效果观察[J].实用临床医药杂志,2017,21(14):55-57.
[15]何红,许亚红,徐国丽,等.“足底操”对0级糖尿病足患者周围神经病变及足底压力的影响[J].现代临床护理,2017,5(2):51-56.