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促进糖尿病患者足溃疡愈合的干预措施指南(2023年更新版)——《国际糖尿病足工作组:糖尿病相关的足病预防与管理指南(2023)》的一部分

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感染、炎症、修复 2024年第1期25卷 23-51页

作者： Pam Chen Nalini Campillo Vilorio Ketan Dhatariya William Jeffcoate Ralf Lobmann Caroline McIntosh Alberto Piaggesi John Steinberg Prash Vas Vijay Viswanathan Stephanie Wu Fran Game on behalf of the International Working Group on the Diabetic Foot 杨彩哲谷熠彬(译) 曹瑛邹梦晨许樟荣(审校) Joondalup Health Campus Ramsay Healthcare AustraliaJoondalupWestern AustraliaAustralia Faculty of Health University of TasmaniaHobartTasmaniaAustralia Department of Diabetology Diabetic Foot UnitPlaza de la Salud General HospitalSanto DomingoDominican Republic Elsie Bertram Diabetes Centre Norfolk and Norwich University Hospitals NHS Foundation TrustNorwichUK Norwich Medical School University of East AngliaNorwichUK Retired physician NottinghamUK Clinic for Endocrinology Diabetology and GeriatricsKlinikum StuttgartStuttgartGermany Podiatric Medicine School of Health SciencesUniversity of GalwayIreland Diabetic Foot Section Department of MedicineUniversity of PisaItaly Georgetown University School of Medicine Washington DCUSA King's College Hospital NHS Foundation Trust LondonUK MV Hospital for Diabetes and Prof M Viswanathan Diabetes Research Center ChennaiIndia Dr.William M.Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science North ChicagoIllinoisUSA University Hospitals of Derby and Burton NHS Foundation Trust DerbyUK 不详空军特色医学中心北京100042 战略支援部队特色医学中心北京100101 南方医院广东广州510515

创面处理的原则,包括清创、创面准备和使用涉及改变创面生理以促进愈合的新技术,在试图治愈慢性糖尿病相关的足溃疡时是至关重要的。此外,糖尿病相关的足溃疡的发病率和治疗成本不断上升,这就需要结合作为金标准的多学科治疗已有共识,... 详细信息

创面处理的原则,包括清创、创面准备和使用涉及改变创面生理以促进愈合的新技术,在试图治愈慢性糖尿病相关的足溃疡时是至关重要的。此外,糖尿病相关的足溃疡的发病率和治疗成本不断上升,这就需要结合作为金标准的多学科治疗已有共识,运用高质量的疗效和成本效益证据来支持和加强慢性糖尿病相关的足溃疡创面愈合的干预措施。本指南是2023年国际糖尿病足工作组(IWGDF)针对促进糖尿病患者足溃疡愈合的干预措施的循证指南。它是对2019年IWGDF指南的更新。我们遵循推荐、评估、发展、评价分级(GRADE)方法,以患者-干预-对照-结果(PICO)形式设计临床问题从而得出重要结果,进行系统综述,制定评判表汇总,并为每个问题撰写推荐和理由。每条推荐的形式都是基于系统综述中发现的证据,并使用GRADE评判汇总项目,包括理想和不理想的效果、证据的可信度、对患者的价值、所需的资源、成本效益、公平性、可行性和可接受性;我们制定的推荐由作者同意并由独立专家和利益相关者审查。根据系统综述和从证据到决策过程的结果,我们提出29条推荐。我们对使用干预措施改善糖尿病患者足溃疡的愈合提出了一些有条件的支持性推荐。这些推荐包括蔗糖八硫酸盐敷料的使用,对手术后的创面使用负压疗法,使用胎盘衍生产品,使用自体白细胞、血小板、纤维蛋白贴剂,使用局部氧疗,以及使用高压氧,但我们强调在任何情况下这些推荐应在单独应用最佳标准治疗无法治愈伤口且有资源可用于干预的情况下使用。这些关于创面愈合的推荐应该有助于提高糖尿病伴足溃疡患者的疗效,我们希望这些推荐能得到广泛的实施。然而,尽管作为推荐基础的许多证据的准确性正在提高,但总体上仍然很差,我们鼓励在这一领域进行更多、质量更好的试验,包括那些有关卫生经济学分析的试验。

关键词：糖尿病足溃疡干预指南国际糖尿病工作组

重症监护与非重症监护患者的压力性损伤患病率:全州范围的比较

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中国护理管理 2017年第9期17卷 1296-1296页

作者： Fiona Coyer Sandra Miles Sandra Gosley Paul Fulbrook Kirstine Sketcher-Baker Jane-Louise Cook Jacqueline Whitmore 昆士兰科技大学护理学院 Metro北卫生服务区Brisbane皇家妇女医院重症监护室 Huddersfield大学皮肤完整和感染预防研究所 Metro北卫生服务区查尔斯亲王医院护理和研究实践发展中心澳大利亚天主教大学助产和医辅护理学院Brisbane校区 Brisbane皇家妇女医院RBWH安全和质量单位 tasmania大学健康科学学院 Herston昆士兰健康卓越临床部患者安全和质量改善服务 Brisbane皇家妇女医院临床护理中心

背景:医院获得性压力性损伤(HAPI)与患病率和病死率的增加有关,被认为在很大程度上是可以预防的。压力性损伤的患病率被视为反映卫生保健质量的一项指标。目的:在全州范围内,比较重症监护室(ICU)患者和非ICU患者的压力性损伤的患病率、... 详细信息

背景:医院获得性压力性损伤(HAPI)与患病率和病死率的增加有关,被认为在很大程度上是可以预防的。压力性损伤的患病率被视为反映卫生保健质量的一项指标。目的:在全州范围内,比较重症监护室(ICU)患者和非ICU患者的压力性损伤的患病率、严重程度和发生部位。方法 :本研究采用二次数据分析设计,从昆士兰州所有拥有Ⅰ-Ⅲ级重症监护室,并参与了2012-2014年昆士兰床旁审计的卫生医院,提取和分析去识别化处理的压力性损伤数据。样本涵盖所有成人ICU患者和非ICU患者,患者均同意参与昆士兰床旁审计。精神卫生单位除外。结果 :除压力性损伤Ⅰ期外,2012-2014年间,ICU患者HAPI的总患病率为11%,非ICU患者为3%;住院期间,ICU患者发展为压力性损伤的可能性是非ICU患者的3.8倍(RR的95%可信区间为2.7~5.4)。对所有患者来说,骶骨/尾骨都是HAPI最常见的部位(ICU患者为22%,非ICU患者为35%)。然而,ICU患者黏膜压力性损伤的比例(22%)显著高于非ICU患者(2%)。压力性损伤Ⅱ期是HAPI患病率最高的阶段,ICU患者为53%,非ICU患者为63%。

关键词：标杆学习危重病患者重症监护压力性损伤压力性溃疡患病率

Childhood Cardiovascular Risk Factors and Adult Cardiovascular Events

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四川生理科学杂志 2022年第2期44卷 53-53页

作者： David R Jacobs Jr From the Division of Epidemiology and Community Health School of Public Health (D.R.J.) and the Department of Pediatrics University of Minnesota Medical School (A.R.S. J.S.) University of Minnesota Minneapolis the Division of Biostatistics and Epidemiology (J.G.W. N.Z.) and the Heart Institute (E.M.U.) Cincinnati Children's Hospital Medical Center and the Department of Pediatrics University of Cincinnati College of Medicine (J.G.W. N.Z. E.M.U.) - both in Cincinnati the Department of Pediatrics University of Colorado School of Medicine and Anschutz Medical Campus Children's Hospital Colorado - both in Aurora (S.R.D.) the Center for Population Health Research (J.I. N.K. C.G.M. O.T.R.) the Research Center of Applied and Preventive Cardiovascular Medicine (J.I. N.K. C.G.M. O.T.R.) and the Departments of Medicine (M.J. J.S.A.V.) and Mathematics and Statistics (N.K.) University of Turku and the Center for Population Health Research (J.I. N.K. C.G.M. O.T.R.) the Division of Medicine (M.J. J.S.A.V.) and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.) Turku University Hospital Turku and the Department of Clinical Chemistry Fimlab Laboratories and the Finnish Cardiovascular Research Center and the Faculty of Medicine and Health Technology Tampere University Tampere (T.L.) - all in Finland Menzies Institute for Medical Research University of Tasmania Hobart TAS (C.G.M. A.J.V. T.D.) and the Heart Research Group Murdoch Children's Research Institute Melbourne VIC (T.D.) - both in Australia the School of Public Health and Tropical Medicine Tulane University New Orleans (L.A.B.) the Department of Epidemiology College of Public Health University of Iowa Iowa City (T.L.B.) the Division of Public Health Sciences Wake Forest School of Medicine Winston-Salem NC (R.J.P.) and the Nuffield Department of Women's and Reproductive Health University of Oxford Oxford United Kingdom (T.D.).

Background:Childhood cardiovascular risk factors predict subclinical adult cardiovascular disease,but links to clinical events are ***:In a prospective cohort study involving participants in the International Childhood Cardiovascular Cohorts(i3C)Consortium,we evaluated whether childhood risk factors(at the ages of 3 to 19 years)were associated with cardiovascular events in adulthood after a mean follow-up of 35 years.

关键词： Cardiovascular cardiovascular Childhood

糖尿病相关的足病的定义和标准(2023年更新版)

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感染、炎症、修复 2024年第1期25卷 80-85页

作者： Jaap J.van Netten Sicco A.Bus Jan Apelqvist Pam Chen Vivienne Chuter Robert Fitridge Frances Game Robert J.Hinchliffe Peter A.Lazzarini Joseph Mills Matilde Monteiro-Soares Edgar J.G.Peters Katherine M.Raspovic Eric Senneville Dane K.Wukich Nicolaas C.Schaper on behalf of the International Working Group on the Diabetic Foot 张会峰(译) 许樟荣(审校) Department of Rehabilitation Medicine Amsterdam UMCLocation University of AmsterdamAmsterdamthe Netherlands Amsterdam Movement Sciences Program RehabilitationAmsterdamthe Netherlands Department of Endocrinology University Hospital of MalmöMalmöSweden Joondalup Health Campus Ramsay HealthcareSydneyAustralia Faculty of Health University of TasmaniaHobartAustralia School of Health Sciences Western Sydney UniversitySydneyAustralia Faculty of Health and Medical Sciences University of AdelaideAdelaideAustralia Vascular and Endovascular Service Royal Adelaide HospitalAdelaideAustralia Department of Diabetes and Endocrinology University Hospitals of Derby and Burton NHS Foundation TrustDerbyUK Department of Vascular Surgery University of BristolBristolUK School of Public Health and Social Work Queensland University of TechnologyBrisbaneAustralia Allied Health Research Collaborative The Prince Charles HospitalBrisbaneAustralia Michael E.DeBakey Department of Surgery Division of Vascular Surgery and Endovascular TherapyBaylor College of MedicineHoustonTexasUSA Portuguese Red Cross School of Health–Lisbon LisbonPortugal MEDCIDS–Departamento de Medicina da Comunidade Informação e Decisão em Saúde Faculty of Medicine of the University of PortoPortoPortugal RISE@CINTESIS Faculty of Medicine Oporto UniversityPortoPortugal Department of Internal Medicine Amsterdam UMCVrije Universiteit AmsterdamSection of Infectious DiseasesAmsterdamthe Netherlands Department of Orthopaedic Surgery University of Texas Southwestern Medical CenterDallasTexasUSA Department of Infectious Diseases Gustave Dron Hospital Tourcoing Univ-lilleTourcoingFrance Div.Endocrinology MUMC+CARIM and CAPHRI InstituteMaastrichtThe Netherlands 不详河南省人民医院内分泌科河南郑州450003 战略支援部队特色医学中心北京100101

糖尿病相关的足病管理涉及多个学科,通用的专业词汇对于各学科间准确沟通交流至关重要。国际糖尿病足工作组(IWGDF)对相关文献进行了系统综述,构成了制定IWGDF指南的基础,并且明确了糖尿病相关的足病的一系列定义、标准及名词解释。本... 详细信息

糖尿病相关的足病管理涉及多个学科,通用的专业词汇对于各学科间准确沟通交流至关重要。国际糖尿病足工作组(IWGDF)对相关文献进行了系统综述,构成了制定IWGDF指南的基础,并且明确了糖尿病相关的足病的一系列定义、标准及名词解释。本文介绍2023年IWGDF对这些定义和标准的更新,并建议在临床实践和研究中一致使用,以利于世界各地不同学科人员针对糖尿病相关的足病的专业性交流。

关键词：定义糖尿病糖尿病相关的足病国际糖尿病足工作组