糖尿病足截肢者临床及康复特征对其预后影响的系统综述

doi:10.3969/j.issn.1006-9771.2024.11.006

Abstract

Abstract:

Objective To analyze the impact of different clinical and rehabilitation characteristics on the prognosis of diabetic foot amputees.

Methods Related literatures were searched in CNKI, Wanfang Data, PubMed, Cochrane Library and Google Scholar from establishment to August, 2024. The literatures were screened and extracted by two researchers independently, the Newcastle-Ottawa Scale (NOS) and the evaluation criteria recommended by Agency for Healthcare Research and Quality (US) were used for quality evaluation, and literatures with above medium quality were included, and a systematic review was conducted.

Results A total of 17 articles involving 9 239 subjects were included, in which three were Chinese, and 14 were English. The study designs were case-control study, cohort study and cross-sectional study. They mainly came from the fields of rehabilitation medicine, orthopedics, sports medicine and disability studies, and were published between 1998 to 2023. Clinical and rehabilitation characteristics related to the prognosis of diabetic foot amputees included amputation level, socioeconomic determinants (educational attainment, economic status, social participation, etc.), psychological states (anxiety, depression, etc.) and physiological factors (age, gender, pain, prosthetic limb usage, and ambulatory capacity, etc.). These different characteristics could affect the quality of life of diabetic foot amputees, and even lead to re-amputation or death.

Conclusion Factors of amputation level, socioeconomic status, psychological status and physiological status are important for poor prognosis in diabetic foot amputees. Controlling the above factors can effectively reduce the re-amputation rate and mortality, and improve the quality of life in diabetic foot amputees, thus improving their prognosis, and promoting functional rehabilitation.

Key words: diabetic foot, amputation, prognosis, quality of life, systematic review

CLC Number:

R587.2

ZHANG Haoyuan, TIAN Gang, LI Xuefeng, LI Hongjiang, MIN Hongwei, TANG Peng, ZHANG Rui, GU Rui, LIU Kemin. Influence of clinical and rehabilitation characteristics on prognosis of diabetic foot amputees: a systematic review[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(11): 1281-1290.

Figures/Tables 5

Table 1

Table 2

Table 3

Figure 1

Table 4

Basic characteristics of included literatures"

纳入文献	国家	研究类型	n	比较	主要结局
Vuorlaakso等^[15](2023)	芬兰	队列研究	1081	不同截肢水平比较不同年龄比较	再截肢率未提及死亡率降低生活质量提高 Barthel指数升高
Reisoğlu等^[16](2022)	土耳其	队列研究	484	不同截肢水平比较不同年龄比较不同性别比较	再截肢率降低死亡率降低生活质量未提及
杨佳等^[17](2021)	中国	病例对照研究	100	不同社会经济状况比较不同心理状况(无情绪障碍与存在焦虑、抑郁)比较不同年龄比较不同疼痛状况(无疼痛与存在残肢痛、幻肢痛)比较	再截肢率未提及死亡率未提及生活质量提高 DSQL得分降低
梁国女等^[18](2019)	中国	病例对照研究	110	不同社会经济状况比较不同心理状况(无情绪障碍与存在焦虑、抑郁)比较不同截肢水平比较不同年龄比较	再截肢率未提及死亡率未提及生活质量提高 DSQL得分降低
Pedras等^[19](2018)	葡萄牙	横断面研究	202	不同心理状况(无情绪障碍与存在焦虑、抑郁)比较	再截肢率降低死亡率降低生活质量提高 SF-36得分升高
Fajardo-Martos等^[20](2018)	西班牙	队列研究	169	不同截肢水平比较不同性别比较不同步行能力比较	再截肢率降低死亡率降低生活质量提高 DSQL得分降低
Davie-Smith等^[21](2017)	英国	队列研究	1735	不同截肢水平比较不同年龄比较装配假肢与未装配假肢比较	再截肢率降低死亡率降低生活质量未提及
Chu等^[22](2016)	中国	队列研究	245	不同截肢水平比较不同年龄比较年轻患者与高龄患者相比不同步行能力比较	再截肢率降低死亡率降低生活质量提高 Barthel指数升高
Venkataraman等^[23](2016)	新加坡	队列研究	256	不同年龄比较不同步行能力比较	再截肢率降低死亡率降低生活质量提高 Barthel指数升高
Siersma等^[24](2014)	意大利	横断面研究	1088	不同截肢水平比较不同心理状况(无情绪障碍与存在焦虑、抑郁)比较不同社会经济状况比较不同疼痛状况(无疼痛与存在残肢痛、幻肢痛)比较不同步行能力比较	再截肢率降低死亡率降低生活质量提高 Barthel指数升高
Wong等^[25](2013)	新加坡	队列研究	151	不同截肢水平比较装配假肢与未装配假肢比较	再截肢率降低死亡率降低生活质量未提及
Morbach等^[26](2012)	德国	队列研究	247	不同截肢水平比较不同年龄比较不同性别比较	再截肢率未提及死亡率降低生活质量提高 Barthel指数升高
Sinha等^[27](2011)	荷兰	横断面研究	605	不同社会经济状况比较不同疼痛状况(无疼痛与存在残肢痛、幻肢痛)比较装配假肢步行能力较好与未装配假肢步行能力较差比较	再截肢率未提及死亡率降低生活质量提高 SF-36得分升高
舒斌等^[28](2010)	中国	队列研究	82	不同截肢水平比较不同年龄比较	再截肢率降低死亡率未提及生活质量未提及
Dillingham等^[29](2008)	美国	队列研究	2468	不同年龄比较装配假肢与未装配假肢比较	再截肢率降低死亡率降低生活质量未提及
Ohsawa等^[30](2001)	日本	队列研究	27	不同年龄比较不同性别比较不同步行能力比较	再截肢率降低死亡率降低生活质量提高 SF-36得分升高
Larsson等^[31](1998)	瑞典	队列研究	189	不同截肢水平比较装配假肢步行能力较好与未装配假肢步行能力较差比较	再截肢率降低死亡率降低生活质量提高 Barthel指数升高

Table 4

References 52

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纳入文献	①	②	③	④	⑤	⑥	⑦	⑩	⑪	得分	质量
Pedras等^[19](2018)	√	√	√	√	√		√			6	中
Siersma等^[24](2014)	√	√	√	√	√	√			√	7	中
Sinha等^[27](2011)	√	√	√	√	√	√		√	√	8	高

Influence of clinical and rehabilitation characteristics on prognosis of diabetic foot amputees: a systematic review

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