摘要
目的 探讨应用负压封闭引流技术（VSD）治疗糖尿病足慢性创面的疗效.方法 选择2006年1月至2013年11月在空军总医院住院治疗的89例糖尿病足（Wagner 3 ～4级）慢性创面,根据治疗方法不同分为对照组（29例,常规抗感染、降糖、调脂、纠正低蛋白血症等全身治疗;同时行创面切开引流、蚕食清创,必要时行跖趾或趾趾关节离断术）和观察组（60例,在对照组基础上应用VSD治疗）,对比2组创面治疗3个月后的疗效及不良反应.结果 观察组湿性坏疽患者平均年龄（54±12）岁,踝肱指数（ABI）（1.08 ±0.10）,应用VSD（2.29±1.07）次,3个月内愈合30例（93.8％）,好转2例（6.2％）;混合性坏疽患者平均年龄（57±9）岁,ABI（1.16±0.13）,应用VSD（1.97±0.74）次,3个月内愈合17例（77.3％）,好转12例（22.7％）;干性坏疽平均年龄（76±10）岁,ABI（0.51 ±0.20）,应用VSD（2.60±1.32）次,3个月内愈合1例,好转5例;干性坏疽患者年龄大于湿性坏疽患者及混合性坏疽,湿性坏疽与混合性坏疽组治愈率比较,差异无统计学意义（P＞0.05）,湿性坏疽及混合性坏疽患者治愈率明显高于干性坏疽患者,差异均有统计学意义（均P＜0.01）.对照组湿性坏疽患者3个月内愈合7例,好转7例;混合性坏疽患者3个月内愈合3例,好转7例;干性坏疽患者治愈1例,好转2例,1例干性坏疽行截趾治疗后因创面无好转,截肢.观察组湿性坏疽、混合性坏疽3个月内创面愈合率明显高于对照组,差异均有统计学意义（均P＜0.05）.2组干性坏疽创面愈合率差异无统计学意义.结论 VSD辅助治疗湿性、混合性无明显缺血糖尿病足的慢性创面可取得良好的效果.适时冲管,调整压力,可预防引流管阻塞、创面周围出现水疱及疼痛的发生.
Objective To investigate the therapeutic effect of utilizing vacuum sealing drainage （VSD） on diabetic foot chronic wounds.Methods A total of 89 patients were enrolled and divided into treatment and control group.Each group was sub-divided according to the characteristics of the wounds：wet gangrene,mixed gangrene and dry gangrene.The cure rate was analyzed and the clinical complications were summarized.Results The mean age of the patients with wet gangrene was （54 ± 12） years with ABI of （1.08 ±0.10） ; after the application of VSDwith （2.29 ±1.07） times,30 of the cases （93.8%） healed and 2 cases （6.2%） improved within 3 months.The mean age of the patients with mixed gangrene was （57 ±9） years with ABI of （1.16 ±0.13） ; after the application of VSD with （1.97 ± 0.74） times,17 cases （77.3%） healed and 14 cases （22.7%） improved within 3 months.The mean age of the patients with dry gangrene was （76 ± 10） years with ABI of （0.51 ± 0.20） ; after the application of VSD （2.60 ± 1.32） times,1 case （16.7%） healed,5 cases （83.3%） improved within 3 months.The dry gangrene patients were older than those in wet and mixed gangrene groups; the differences were statistically significant （P 〈0.01） ; the wet gangrene and the mixed gangrene group showed no significant differences （P 〉0.05）.The wound healing rates in wet and mixed gangrene groups were significantly higher than those in the dry gangrene group （P 〈0.01）.Within 3 months,in the control group,7 cases （50.0%） of wet gangrene healed and 7 cases （50.0%） improved; 3 cases （30.0%） of mixed gangrene healed and 7 cases （70.0%） improved; 1 case （20.0%） of dry gangrene healed and 2 cases （40.0%） improved.In the VSD treatment group,the healing rates of the wet and mixed gangrene patients were significantly higher than in the control group within 3 months （P 〈 0.05）.The healing rates had no significant differenc e between the 2 groups of dry gangrene patients.Co
出处
《中国医药》
2014年第12期1761-1765,共5页
China Medicine
