PDF(Pubmed)
Abstract：
Diabetic foot osteomyelitis (DFO) poses a significant challenge in the management of diabetic patients, often leading to severe complications and increased morbidity. Effective management of DFO requires a multidisciplinary approach, involving endocrinologists, infectious disease specialists, vascular surgeons, orthopaedic surgeons, and wound care experts. Early diagnosis is paramount, facilitated by advanced imaging techniques such as magnetic resonance imaging (MRI) and bone scintigraphy. Once diagnosed, the treatment strategy hinges on a combination of medical and surgical interventions. Antibiotic therapy, guided by culture results, plays a central role in managing DFO. Tailored regimens targeting the specific pathogens involved are administered, often for prolonged durations. Surgical intervention becomes necessary when conservative measures fall short. Surgical approaches range from minimally invasive procedures, like percutaneous drainage, to more extensive interventions like debridement and bone resection. Prevention of DFO recurrence is equally vital, emphasising glycemic control, meticulous foot care, patient education, monitoring of at-risk signs, revascularization and early intervention when indicated. The management of diabetic foot osteomyelitis mandates a comprehensive strategy that addresses both the infectious and surgical aspects of the condition. A collaborative, interdisciplinary approach ensures timely diagnosis, tailored treatment, and holistic care. Further research into novel therapeutic modalities and long-term outcomes remains essential in refining the management of this complex and debilitating complication of diabetes.
摘要：
糖尿病足骨髓炎（DFO）对糖尿病患者的管理提出了重大挑战，通常导致严重的并发症和发病率增加。有效管理DFO需要多学科的方法，涉及内分泌学家，传染病专家,血管外科医生,整形外科医生,还有伤口护理专家.早期诊断至关重要，先进的成像技术，如磁共振成像（MRI）和骨闪烁显像。一旦确诊,治疗策略取决于医疗和手术干预的结合。抗生素治疗,以文化成果为指导，在管理DFO中起着核心作用。针对所涉及的特定病原体进行量身定制的方案，通常持续很长时间。当保守措施不足时，必须进行手术干预。手术方法包括微创手术，比如经皮引流,更广泛的干预措施，如清创和骨切除。预防DFO复发同样重要，强调血糖控制，细致的足部护理,患者教育,监测有风险的迹象，必要时进行血运重建和早期干预。糖尿病足骨髓炎的管理需要一项全面的策略，以解决该疾病的感染和手术方面。合作，跨学科方法确保及时诊断，量身定制的治疗，和整体护理。对新的治疗方式和长期结果的进一步研究对于完善糖尿病这种复杂且使人衰弱的并发症的管理仍然至关重要。
