第二型糖尿病患足部潰瘍之相關因素探討

Factors Associated with Foot Ulcers in Type 2 Diabetic Patients

10.6225/JEBN.2.2.137

蔡奉宏(Fong-Hung Tsai)；陳清惠(Ching-Huey Chen)；顏妙芬(Miao-Fen Yen)；唐福瑩(Fu-In Tang)

第二型糖尿病 ； 足部潰瘍 ； 病例對照法 ； type 2 diabetes mellitus ； foot ulcers ； case control

實證護理

2卷2期（2006 / 06 / 01）

137 - 146

繁體中文

糖尿病足部潰瘍為造成糖尿病患入院及死亡之重要原因之一。足部的潰瘍不但會影響糖尿病患者的生活品質，更增加了醫療保健之花費。但在台灣有關糖尿病足部潰瘍影響因素相關的研究卻十分有限，若無法了解相關的影響因素，臨床專業人員將難以研擬有效的因應策略，以預防糖尿病足部潰瘍之發生。故本研究目的在探討第二型糖尿病病患足部潰瘍的影響因素。研究採病例對照研究法(case-control study)，以立意取樣方式於台南地區一所醫學中心及區域醫院進行收案。病例組30名個案，為足部潰瘍住院之第二型糖尿病患者；對照組60名個案，為內科門診無足部潰瘍病史之第二型糖尿病患者。研究結果顯示，病例組之平均糖化血色素值(HbA1c)(9.46%)高於對照組(7.23%)，發生周邊神經及周邊血管病變的比率亦高於對照組。足部自我照顧行為得分，病例組則低於對照組。逐步複回歸分析顯示，糖化血色素、周邊神經病變及周邊血管病變是足部潰瘍發生的重要決定因子。

Diabetic foot ulcer is one of the major causes of mortality among DM patients. It may affect the quality of life of its victims and raise their healthcare expenses. However, limited studies have been conducted in Taiwan to explore the determinants of foot ulcer among DM patients. Until these determinants are fully understood, it will be difficult for health professionals to develop effective strategies to reduce the prevalence of the condition among DM patients. The purpose of this study was to investigate the factors associated with foot ulceration in patients with Type 2 diabetes. A case control study was conducted in a medical center and a community hospital in southern Taiwan. Thirty hospitalized diabetic patients with foot ulcers were recruited to join the experimental group and 60 OPD Type 2 diabetic patients without history of foot ulcers were recruited to join the control group. The results indicated that the patients with foot ulcers had higher HbA1c levels (9.46% vs 7.23%), higher incidence of peripheral neuropathy and peripheral vascular disorder, and lower diabetic foot-care behavior scores than those without foot ulcers. The results of logistic regression analysis showed that HbA1c level, peripheral neuropathy, and peripheral vascular disorder were significantly associated with dia¬betic foot ulcers.