糖尿病至今仍是國人十大死因之第五位，而足部潰瘍是造成糖尿病死亡的主因之一，除此之外，糖尿病足部潰瘍不僅造成病患的生理痛苦，更造成心裡及社會功能的威脅，嚴重影響個人生活品質，還帶來社會經濟的負擔。
　　本文針對糖尿病患者足部潰瘍相關研究文獻，彙整糖尿病足部潰瘍的相關影響因素，共分為人口學屬性、疾病狀況、生理狀況、足部病變及足部自我照顧行為等方面分析整理。目的為探討第二型糖尿病病患足部潰瘍的相關因素，研究設計採病例對照研究（case-control study），自91年4月至91年7月，以立意取樣方式於台南地區二所醫學中心及一所區域醫院進行收案，收集因足部潰瘍而住院之第二型糖尿病病患為病例組30名，及內科門診無足部潰瘍病史之第二型糖尿病病患為對照組60名，於個案同意後收集資料，資料收集藉由病歷回顧、結構式問卷並作足部病變的評估。利用SPSS 10.0 For Windows套裝電腦軟體進行計數、百分比、平均值及標準差、t檢定、卡方檢定及logistic regression等統計分析法，檢定兩組病患人口學屬性、疾病狀況、生理狀況、足部病變及足部自我照顧行為等資料，並找出足部潰瘍的相關危險因素。
　　研究結果顯示，病例組比對照組病患有較高的糖化血色素，其平均各為9.46%、7.23%（p<.05），而足部自我照顧行為方面，病例組比對照組病患有較低的足部自我照顧行為得分，其平均各是60.07分、66.53分（p<.01），另外，關於足部病變方面，病例組比對照組有高比例是周邊神經及周邊血管病變問題，最後以logistic regression分析第二型糖尿病病患足部潰瘍的相關因素，發現糖化血色素、周邊神經病變及周邊血管病變是足部潰瘍發生的重要獨立變項，而足部自我照顧行為則否。並且顯示糖化血色素大於7.23%時，其足部潰瘍危險性增為2.54倍，若第二型糖尿病病患有周邊神經及血管病變，其發生足部潰瘍的危險性各約為15倍。另外，引起足部潰瘍傷口的原因，以足部保養行為不當因素（包括鞋具不適、皮膚乾裂、撕扯硬皮及過度修剪趾甲）最多，共佔50%；而受傷部位，以腳趾居多（包括大拇趾及其他四趾），共佔46.7%。
　　此次研究結果可提供醫護人員確認第二型糖尿病病患足部潰瘍的主要相關因素，並讓醫護人員針對具有相關因素問題之病患，實施特定的治療或衛教，以降低糖尿病患足部潰瘍的發生，並作為臨床、教學及研究照護的參考。

　　Diabetes is the fifth leading cause of death in Taiwan. Diabetic Foot Ulcer is one of the major causes of mortality among DM patients. The foot ulcer may induce not only physical suffering among DM patients, but also severely influence their psychological and social function. The quality of life of these patients may be disrupted and the substantial healthcare expenses may increase. However, limited studies have been conducted in Taiwan to explore the determinants of foot ulcer among DM patients. It is not until these determinants are fully understood, it is difficult for health professionals to develop effective strategies to prevent the foot ulcer prevalence in DM patients.
　　Based on the results of the literature review, this study will first list those related factors of diabetic foot ulcer. The severity of the factors as influencing on the developing of diabetic foot ulcer will then be investigated. The factors include demographic characters, disease conditions, physical conditions, foot conditions, and self-care behaviors of foots.
　　Case-control study will be conducted to determine the major influencing factors of foot ulcer. Purposive sample method will be applied to recruit subjects from two medical centers and one hospital in Tainan. Thirty DM patients with foot ulcer and 60 DM patients without foot ulcer history will be recruited. Data will be collected through medical records, physical examinations, and structured questionnaires. SPSS 10.0 for Windows will be used to analyze the data which included descriptive statistics, chi-square, t-test, and logistic regression.
　　The results showed that diabetic patients with foot ulcers had a significantly higher HbA1c and lower self foot care practice scores. They also had more serious questions about peripheral neuropathy and vascular disease. Logistic regression analysis indicated that there were three determinants which were HbA1c, peripheral neuropathy and peripheral vascular disease. And the most factors contributing to the development of ulcers were adequate foot care behaviors.
　　The results of this study may enhance the understanding of health professions to the determinants of foot ulcer among DM patients. As a result, effective strategies can be developed, and the care of the DM patients may be improved.

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