Abstract: Objective:To systematically evaluate the effect of risk stratification management on preventing diabetic foot ulcer.Methods:Randomized Clinical Trials（RCTs） that assessed the effectiveness of risk stratification management in patients with diabetes foot ulcer were systematically reviewed using multiple electronic databases.Strict literature quality evaluation was conducted with reference to Cochrane handbook 5.1.0, and meta-analysis was conducted with RevMan5.3 software. Results: 8 RCTs and 1295 patients were included. Compared with the control group, the risk classification management model reduced the occurrence of diabetic foot ulcer by 3%, and the difference was statistically significant[RD=-0.03, 95%CI(-0.05,0.00), P=0.04].The arterial ankle brachial index(ABI) was higher than those of the control group (P<0.001). The motor nerve conduction velocity[MD=3.53, 95%CI (2.02,5.05), P<0.01] and sensory nerve conduction velocity[MD=4.53, 95%CI(2.93,6.13), P<0.01] were significantly superior to control group. Conclusion: Compared to routine health management, the risk stratification management model can effectively prevent diabetic foot ulcer and improve the status of patients’ arteries and peripheral nerves.

Key words:  , Diabetic foot ulcer, Stratification management, Prevention, Meta-analysis

摘要： 目的：评价风险分级管理模式对糖尿病足溃疡的预防效果。方法：运用Meta分析法，检索中英文数据库搜集风险分级管理模式对糖尿病足溃疡预防效果的临床随机对照试验，参照Cochrane系统评价手册5.1.0进行文献质量评价，采用RevMan 5.3软件进行Meta分析。 结果：最终纳入8篇随机对照试验（RCT）研究，1295例研究对象。相较于对照组，风险分级管理模式降低了3% 的糖尿病足溃疡发生风险，差异有统计学意义[RD=-0.03, 95%CI(-0.05,0.00), P=0.04]。风险分级管理组的动脉踝肱指数（ABI）高于对照组，差异有统计学意义（P＜0.001）。同时，风险分级管理组的运动神经传导速度[MD=3.53, 95%CI(2.02,5.05), P<0.01]和感觉神经传导速度[MD=4.53, 95%CI（2.93,6.13）,P<0.01]优于对照组，且有统计学意义。结论：风险分级管理模式在糖尿病足溃疡预防的应用效果显示出优越性。相较于常规健康管理，该管理模式可以降低DF的发病率，明显改善患者动脉血管及周围神经状况。

关键词: 糖尿病足溃疡, 分级管理, 预防, Meta分析