8-赵宏谋-活动期糖尿病夏科神经性骨关节病诊疗指南

国际糖尿病足工作组：糖尿病相关的足病预防与管理指南(2023)】·127·D0I:10.3969/j.ssn.1672-8521.2023.02.003引用格式：赵宏谋，徐俊（译），张明珠（审校）.活动期糖尿病夏科神经性骨关节病诊疗指南一《国际糖尿病足工作组：糖尿病相关的足病预防与管理指南(2023)》的一部分[J].感染、炎症、修复，2024,25(2)：120-139.活动期糖尿病夏科神经性骨关节病诊疗指南《国际糖尿病足工作组：糖尿病相关的足病预防与管理指南(2023)》的一部分Guidelines on the diagnosis and treatment of active Charcot neuro-osteoarthropathy in persons with diabetesmellitus:Part of the 2023 IWGDF Guidelines on the prevention and management of diabetes-related foot diseaseDane K.Wukich',Nicolaas C.Schaper2,Catherine Gooday,Arun Bal,Robert Bem',Avneesh Chhabra,Mary Has-tings',Crystal Holmes,Nina L.Petrova,Maria Gala Santini Araujo,Eric Senneville,Katherine M.Raspovic',on be-half of the International Working Group on the Diabetic Foot1.Department of Orthopaedic Surgery,University of Texas Southwestem Medical Center,Dallas,Texas,USA;2.Divi-sion of Endocrinology,MUMC+,CARIM and CAPHRI Institute,Maastricht,the Netherlands;3.Elsie Bertram DiabetesCentre,Norfolk Norwich University Hospitals NHS Foundation Trust,Norfolk,UK;4.Secretary,Intemational Associ-ation of Diabetic Foot Surgeons,Mumbai,India;5.Diabetes Centre,Institute for Clinical and Experimental Medicine,Prague;6.Department of Radiology,UT Southwestern Medical Center,Dallas,Texas,USA;7.Program in PhysicalTherapy,Washington University School of Medicine,St.Louis,Missouri,USA;8.The Division of Metabolism,Endocri-nology and Diabetes,The University of Michigan Medical School,Ann Arbor,Michigan,USA;9.Department of Diabe-tes,Diabetic Foot Clinic,King's College Hospital NHS Foundation Trust,London,UK;10.Italian Hospital of BuenosAires,Buenos Aires,Argentina;11.Department of Infectious Diseases,Gustave Dron Hospital,Tourcoing,France赵宏谋·徐俊（译）张明珠（审校）(1.西安交通大学医学院附属红会医院，陕西西安710054：2.天津医科大学朱宪彝纪念医院，天津300314：3.首都医科大学附属同仁医院，北京100730)【摘要】国际糖尿病足工作组(IWGD)自1999年以来发布了糖尿病足病预防和治疗的循证指南。这是IWGDF发布的第一部关于糖尿病患者活动期夏科神经性骨关节病诊断和治疗的指南。我们遵循GRADE方法，以人群-评估-比较-结局(PAC0)和人群-干预-比较-结局(PIC0)的格式设计临床问题，系统检索医学文献，并提出有依据的推荐。这些推荐是基于我们系统综述的证据，如无证据则参考专家意见，并考虑到与干预相关的受益和危害、患者偏好、可行性和适用性以及成本的权衡。我们在本章节介绍了2023年糖尿病患者活动期夏科神经性骨关节病的诊断和治疗指南，并提出了未来的关键研究方向。【关键词】糖尿病；夏科神经性骨关节病，活动期；诊断；治疗；国际糖尿病足工作组；指南www.iwgdfguidelines.org中图分类号：R587.2:R-01文献标识码：C缩写国际糖尿病足工作组AFO:ankle foot orthosis,足踝支具MRI:magnetic resonance imaging,磁共振成像CNO:Charcot neuro-osteoarthropathy,夏科神经性骨关节PTH:parathyroid hormone,甲状旁腺激素病推荐清单CROW:Charcot restraining orthotic walker,夏科限制型行走靴活动期CNO诊断CT:computed tomography,计算机断层扫描1.对于合并糖尿病神经病变但同时皮肤完整的患者，IWGDF:Intemational Working Group on the Diabetic Foot,一旦出现患足相对于对侧皮温升高、水肿，伴或不伴有皮