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Abstract：
This study analyzed the influence of diabetic nephropathy on the healing prognosis after conservative surgery in diabetic foot osteomyelitis (DFO). A retrospective observational study was carried out between January 2021 and December 2022 and involved 278 outpatients with a diagnosis of DFO at a specialized diabetic foot unit, including 74 (26.62%) patients with DN (group 2) and 204 (73.38%) patients without DN (group 1). There were 266 (95.70%) ulcers on the forefoot, 8 (2.90%) on the midfoot, and 4 (1.45%) on the hindfoot (p = 0.992). The healing rates were 85.1% (n = 63) for group 2 and 81.3% (n = 165) for group 1 (p = 0.457). When exploring the influence of DN on the risk of delayed ulcer healing, the results did not show a significant effect [12 (6; 28) weeks among patients with DN vs. 12 (6; 21) weeks among patients without DN; p = 0.576]. No significant differences were observed in complications, with one (2.59%) death occurring in group 1 (p = 0.296) and three minor amputations being performed in both groups [two (5.13%) amputations in group 1 vs. one amputation (9.09%) in group 2; p = 0.217]. Bone cultures were performed for a total of 190 patients (133 in group 1 and 57 in group 2). Of these, 176 positive bone cultures were isolated: 71 positive bone cultures (57.7%) were monomicrobial cultures in group 1, with 30 (56.6%) in group 2. There were 52 (42.3%) that had at least two microorganisms in group 1, and 23 (43.4%) in group 2 (p = 0.890). The most frequently prescribed oral antibiotic was amoxicillin/clavulanate (43.89%), followed by levofloxacin (28.4%), and trimethoprim/sulfamethoxazole (14.7%). This study shows that DN does not have a significant influence on the healing prognosis of patients with DFO after conservative surgery.
摘要：
本研究分析糖尿病肾病对糖尿病足骨髓炎(DFO)保守性手术后愈合预后的影响。在2021年1月至2022年12月之间进行了一项回顾性观察研究，涉及278名在专门的糖尿病足单位诊断为DFO的门诊患者。其中DN患者74例(26.62%)(第2组)和非DN患者204例(73.38%)(第1组)。前足有266个(95.70%)溃疡,8（2.90％）在中足，后脚为4（1.45％）（p=0.992）。2组的治愈率为85.1％（n=63），1组的治愈率为81.3％（n=165）（p=0.457）。探讨DN对溃疡延迟愈合风险的影响,结果在DN患者中没有显着影响[12（6;28）周无DN患者的12（6；21）周；p=0.576]。在并发症方面没有观察到显著差异。在第1组中发生1例（2.59％）死亡（p=0.296），两组均进行了3次小截肢[第1组中有2例（5.13％）截肢与第2组1例截肢（9.09%）；p=0.217]。总共190例患者进行了骨培养（第1组133例，第2组57例）。其中,分离出176个阳性骨培养物：第1组71个阳性骨培养物（57.7％）为单抗微生物培养物，第2组30个（56.6％）。第1组中有52例（42.3％）具有至少两种微生物，第2组中有23例（43.4％）（p=0.890）。最常用的口服抗生素是阿莫西林/克拉维酸（43.89%），其次是左氧氟沙星（28.4%），甲氧苄啶/磺胺甲恶唑(14.7%)。本研讨显示DN对保守性手术后DFO患者的医治预后没有显著影响。
