封閉式負(fù)壓引流聯(lián)合前列地爾治療糖尿病足潰瘍的臨床療效分析

吳繼紅 王海云 孔彩霞 齊秦 劉曉萍 韓曉麗 郝開花

[摘要] 目的 觀察封閉式負(fù)壓引流聯(lián)合前列地爾治療糖尿病足潰瘍的臨床療效。方法 隨機(jī)選擇2018年1月—2019年12月至該院進(jìn)行糖尿病足潰瘍治療的患者100例進(jìn)行臨床研究。使用隨機(jī)數(shù)字法將患者分為觀察組和對(duì)照組，各50例，所有患者均給予控制血糖和前列地爾治療。對(duì)照組患者創(chuàng)面給予常規(guī)換藥，觀察組患者給予封閉式負(fù)壓引流。比較兩組患者創(chuàng)面愈合時(shí)間、住院時(shí)間以及治療前后疼痛評(píng)分和潰瘍面積變化情況。比較兩組患者臨床療效。 結(jié)果觀察組患者創(chuàng)面愈合時(shí)間、住院時(shí)間均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（t=3.637、4.000，P<0.05），兩組患者治療前VAS評(píng)分和潰瘍面積差異無統(tǒng)計(jì)學(xué)意義（P>0.05），治療后與該組治療前相比均明顯降低（P<0.05），但觀察組VAS評(píng)分和潰瘍面積治療后均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（t=5.177、8.678，P<0.05）;觀察組治療總有效率為96.00%，明顯高于對(duì)照組84.00%，差異有統(tǒng)計(jì)學(xué)意義（χ2=4.000，P=0.046）。結(jié)論 封閉式負(fù)壓引流聯(lián)合前列地爾對(duì)于糖尿病足潰瘍具有很好的臨床療效，明顯縮短病程，減輕患者疼痛，縮小潰瘍面積，提高患者生活質(zhì)量。

[關(guān)鍵詞] 封閉式負(fù)壓引流;前列地爾;糖尿病足;潰瘍

[中圖分類號(hào)] R4? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-0742（2020）10（c）-0054-03

[Abstract] Objective To observe the clinical efficacy of closed negative pressure drainage combined with alprostadil in the treatment of diabetic foot ulcers. Methods Randomly select 100 patients who were treated for diabetic foot ulcer in the hospital from January 2018 to December 2019 for clinical research. The patients were divided into observation group and control group by random number method， each with 50 cases. All patients were given blood glucose control and alprostadil treatment. Patients in the control group were given routine dressing changes on their wounds， and patients in the observation group were given closed negative pressure drainage. The wound healing time， hospitalization time， pain score and ulcer area changes before and after treatment were compared between the two groups. Compare the clinical efficacy of the two groups of patients. Results The wound healing time and hospitalization time of the observation group were lower than those of the control group，and the difference was statistically significant（t=3.637，4.000，P<0.05）. The VAS score and ulcer area of the two groups before treatment were not statistically significant difference（P>0.05）. After treatment， compared with the group before treatment， both were significantly reduced（P<0.05）， but the VAS score and ulcer area of the observation group after treatment were lower than those of the control group， and the difference was statistically significant （t=5.177，8.678，P<0.05）; the total effective rate of treatment in the observation group was 96.00%， which was significantly higher than that of the control group 84.00%，and the difference was statistically significant（χ2=4.000， P=0.046）. Conclusion Closed negative pressure drainage and alprostadil have a good clinical effect on diabetic foot ulcers， which can shorten the course of the disease， reduce the pain of patients， reduce the area of ulcers， and improve the quality of life of patients.

綜上所述，封閉式負(fù)壓引流聯(lián)合前列地爾對(duì)于糖尿病足潰瘍具有很好的臨床療效，能明顯縮短病程，減輕患者疼痛，縮小潰瘍面積，提高患者生活質(zhì)量。

[參考文獻(xiàn)]

[1]? Tan L，Hou Z，Gao Y.Efficacy of combined treatment with vacuum sealing drainage and recombinant human epidermal growth factor forrefractory wounds in the extremities and its effect on serum levels of IL-6， TNF-α and IL-2[J].Exp Ther Med， 2018，1 5（1）：288-294.

[2]? 國(guó)際血管聯(lián)盟中國(guó)分會(huì)糖尿病足專業(yè)委員會(huì).糖尿病足診治指南[J].介入放射學(xué)雜志，2013，22（9）：705-708.

[3]? 中華醫(yī)學(xué)會(huì)糖尿病學(xué)分會(huì).中國(guó)2型糖尿病防治指南（2013年版）[J].中華糖尿病雜志，2014（7）：447-498.

[4]? 許樟榮，王玉珍.糖尿病足的綜合防治和分級(jí)管理[J].中國(guó)醫(yī)刊，2017，52（2）：11-14.

[5]? 周麗華，陳清華，陳宗存，等.自體富血小板凝膠聯(lián)合封閉式負(fù)壓引流術(shù)治療糖尿病足潰瘍的效果觀察[J].中國(guó)醫(yī)學(xué)前沿雜志：電子版，2017，9（6）：131-134.

[6]? 倪少俊，徐秋月，楊軍，等.含氧生理鹽水間斷沖洗聯(lián)合負(fù)壓封閉引流治療糖尿病肢體慢性潰瘍的效果觀察[J].海南醫(yī)學(xué)，2018，29（2）：190-192.

[7]? 童利偉，劉真，羅富瓊，等.持續(xù)封閉負(fù)壓吸引治療糖尿病足的療效觀察[J].西南軍醫(yī)，2017，19（6）：523-524.

[8]? 龔磊，黎濤，楊月蓮，等.前列地爾聯(lián)合VSD負(fù)壓吸引治療糖尿病足潰瘍療效分析[J].中國(guó)臨床新醫(yī)學(xué)，2017，10（12）：1197-1198.

[9]? 郭正祥，章伏生，王史輝，等.封閉式負(fù)壓引流聯(lián)合前列地爾治療糖尿病足潰瘍創(chuàng)面愈合的臨床療效觀察[J].中國(guó)現(xiàn)代醫(yī)生，2019，57（20）：100-103.

[10]? 弓軍勝，蘭麗珍.封閉式負(fù)壓引流聯(lián)合前列地爾治療糖尿病足潰瘍的臨床觀察[J].中西醫(yī)結(jié)合心腦血管病雜志，2019， 16（13）：1940-1942.

（收稿日期：2020-07-26）