糖尿病合併足部潰瘍患者之營養評估及介入

(1)

糖尿病合併足部潰瘍患者之營養評估及介入

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糖尿病患者因長期血糖控制不良容易導致週邊血管及神經病變。一旦不慎產生傷口，傷口經常不容易癒合，也是導致糖尿病患者截肢的最主要原因。在之前的研究得知，傷口的癒合與營養狀態及蛋白質攝取息息相關。因此本研究的目的首先先觀察一般糖尿病合併有足部潰瘍的患者其營養狀態；再針對需接受膝下截肢的患者在手術後，於一般飲食之外補充 16 公克的蛋白質，觀察對其營養狀態的影響。研究結果發現，糖尿病合併足部潰瘍的患者其營養狀態的指標，包括 hemoglobin 、 albumin 、 prealbumin 、 tr ansferrin 及與傷口癒合相關之營養素 zinc 均較一般參考值低。而在對患者於截肢手術後補充 16 公克的蛋白質的部份則發現，患者手術前與手術後之營養狀況有改善之趨勢但無明顯統計上的差異。可能的原因有：補充的量不足、

觀察時間太短、收集人數不足及個體的差異性等。

(2)

The evaluation & intervention of nutrition in diabetic patients with foot ulcer

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Diabetic patients are susceptible to peripheral vascular and neurological co

mplications due to long term poor blood glucose control. Injuried wounds i

n such patients are difficult in healing, which is the most common etiology

resulting in amputation. Accoring to prior studies, there are close relations

糖尿病合併足部潰瘍患者之營養評估及介入



The evaluation & intervention of nutrition in diabetic patients with foot ulcer

Diabetic patients are susceptible to peripheral vascular and neurological co

mplications due to long term poor blood glucose control. Injuried wounds i

n such patients are difficult in healing, which is the most common etiology

resulting in amputation. Accoring to prior studies, there are close relations

between wound healing, nutritional status and protein intake. The major pu

rpose of this study is to monitor the nutritional status in diabetic patients co

mbined with foot ulcer, followed by the nutritional influence in patients rec

eived below-knee amputation with further 16 grams protein supply in addit

ion to general diet. The result disclosed the indicators for the nutritional sta

tus in diabetic patients combined with foot ulcer, including hemoglobin, al

bumin, prealbumin and transferrin, were all below reference level, as well

as zinc, the nutrient that associate with wound healing. In patients received

below-knee amputation with additional 16 grams protein supply, the nutriti

onal status before and after the surgery has a trend toward improve but no s

tatistic difference. The possible explanation may be insufficient supplemen

t, short follow up period, low patient numbers and the individual difference

s.