摘要
目的探究复方黄柏液负压滴灌对糖尿病足创面细菌感染生物膜形成的影响。方法选取巨野县人民医院2019年4月-2021年4月糖尿病足患者118例,随机分为对照组和研究组,各59例;研究组采用复方黄柏液负压滴灌治疗,对照组采用盐水负压滴灌治疗。比较两组患者治疗各阶段创面愈合情况、血清炎症因子、血管内皮功能、创面细菌培养结果及光镜、电镜下创面生物膜形成情况。结果治疗前两组患者创面面积、肉芽组织面积、血清炎症因子、血管内皮功能、创面细菌培养结果差异无统计学意义;治疗2周和4周时,研究组创面面积、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、内皮素(ET)、血栓烷苏B2(TXB2)及细菌培养阳性率低于对照组(P<0.05),肉芽组织面积和一氧化氮(NO)高于对照组(P<0.05);光镜、电镜观察结果显示,治疗前,两组患者创面组织内存在大量的细菌聚集,且蛋白-粘多糖物质包裹细菌形成生物膜,治疗4周,研究组未见明显的细菌聚集及细菌生物膜,情况明显优于对照组。结论复方黄柏液负压滴灌可有效促进糖尿病足创面愈合,在减轻炎性因子水平、改善血管内皮功能、清除病原菌及抑制细菌生物膜形成方面效果优于盐水负压滴灌治疗。
OBJECTIVE To explore the effects of negative-pressure instillation with Fufang Huangbaiye on the formation of bacterial infection biofilm in diabetic foot.METHODS A total of 118 patients with diabetic feet were enrolled between Apr.2019 and Apr.2021.They were randomly divided into control group and observation group,59 cases in each group.The observation group was treated with negative-pressure instillation of Fufang Huangbaiye,while control group was treated by negative-pressure instillation of saline water.The wound healing,serum inflammatory factors,vascular endothelial function,culture results of wound bacteria,and the formation of wound biofilm under light and electron microscopes were compared between the two groups.RESULTS Before treatment,there was no significant difference in wound area,granulation tissue area,serum inflammatory factors,vascular endothelial function or culture results of wound bacteria between the two groups.After 2 and 4 weeks of treatment,wound area,C-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis factorα(TNF-α),endothelin(ET),thromboxane B2(TXB2)and positive rate of bacterial culture in observation group were lower than those in control group(P<0.05),while granulation tissue area and level of nitric oxide(NO)were higher than those in control group(P<0.05).The observation results of light and electron microscopes showed that there were a lot of bacteria in wound tissues of both groups before treatment.The bacteria were wrapped by protein-mucopolysaccharide to form the biofilm.After 4 weeks of treatment,there was no obvious bacterial aggregation or bacterial biofilm in observation group,and the situations were significantly better than those in control group.CONCLUSION The negative-pressure instillation with Fufang Huangbaiye can effectively promote wound healing of diabetic foot,which is better than negative-pressure instillation of saline water in terms of reducing levels of inflammatory factors,improving vascular endothelial function,cleaning pathogens and inhibiting the
作者
沈增运
朱业靖
郝帅
姚中侠
李洁
李明
SHEN Zeng-yun;ZHU Ye-jing;HAO Shuai;YAO Zhong-xia;LI Jie;LI Ming(Juye County People's Hospital,Heze,Shandong 274900,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第19期2992-2996,共5页
Chinese Journal of Nosocomiology
基金
山东省科研计划基金资助项目(2019D03221)。
关键词
糖尿病足
复方黄柏液
负压滴灌
细菌生物膜
Diabetic foot
Fufang Huangbaiye
Negative-pressure instillation
Bacterial biofilm
