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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

34

期数:

2017年5

页码:

394-397

栏目:

临床研究

出版日期:

2017-05-05

文章信息/Info

Title:

Clinical effect of vacuum sealing drainage combined with topical oxygen therapy for the patients with chronic wounds of diabetic foot

作者:

刘伯语¹; 申　科¹; 翟锴华²; 翁孝刚¹; 杜　玮¹

（1.新乡医学院第三附属医院内分泌科，河南　新乡　453003；2.郑州大学第一附属医院神经内科，河南　郑州　450052）

Author(s):

LIU Bo-yu¹; SHEN Ke¹; ZHAI Kai-hua²; WENG Xiao-gang¹; DU Wei¹

（1.Department of Endocrinology，the Third Affiliated Hospital of Xinxiang Medical University，Xinxiang 453003，Henan Province，China；2.Department of Neurology，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，Henan Province，China）

关键词:

负压引流技术; 局部加氧; 糖尿病足; 慢性创面

Keywords:

vacuum sealing drainage; topical oxygen therapy; diabetic foot; chronic wounds

分类号:

R587.2

DOI:

10.7683/xxyxyxb.2017.05.012

文献标志码:

A

摘要:

目的　观察负压封闭引流（VSD）技术联合局部加氧（TOT）治疗糖尿病足慢性创面的临床疗效。方法　将2013年1月至2015年12月新乡医学院第三附属医院收治的糖尿病足患者42例随机分为观察组和对照组，每组21例。对照组患者采用常规治疗和VSD，观察组患者采用常规治疗联合VSD和TOT。2组患者入院后均行清创术，检测入院时和治疗7 d时创面中的乳酸脱氢酶（LDH）和琥珀酸脱氢酶（SDH）的活性，检测治疗7 d时创面组织液氧分压。根据创面溃疡面积和脓性物变化判定临床疗效。结果　2组患者治疗前创面局部组织液氧分压、创面肉芽组织中LDH、SDH活性、溃疡面积比较差异均无统计学意义（P>0.05）。治疗后第7天观察组患者创面局部组织液氧分压为（111.99±3.75）mmHg（1 mmHg=0.133 kPa），高于对照组的（42.99±4.14）mmHg（P<0.05）；与治疗前比较，治疗7 d后2组患者创面肉芽组织中LDH活性均显著降低，SDH活性均显著升高（P<0.01）；治疗7 d后，观察组患者创面肉芽组织中LDH活性低于对照组（P<0.01），SDH活性高于对照组（P<0.01），溃疡面积、脓性分泌物改善状况显著优于对照组（P<0.05）。观察组患者治疗有效率（90.5%）高于对照组（71.4%）（χ²=18.640，P<0.05）。结论　VSD联合TOT能促进糖尿病足慢性创面修复，提高临床疗效，其机制可能与提高创面组织的氧分压、LDH活性及降低SDH活性有关。

Abstract:

Objective　To evaluate the clinical therapeutic effect of vacuum sealing drainage（VSD）combined with topical oxygen therapy（TOT）for the patients with chronic wound of diabetic foot.Methods　Forty-two patients with chronic wound of diabetic foot in the Third Affiliated Hospital of Xinxiang Medical University from January 2013 to December 2015 were randomly divided into control group and observation group，21 cases in each group.The patients in the control group were treated by conventional therapy combined with VSD，while the patients in the observation group were given conventional therapy combined with VSD and TOT.All the patients in the two groups were given debridement after hospitalized.The activities of lactate dehydrogenase（LDH）and succinate dehydrogenase（SDH）in granulation tissue of wound on admission and after treated for seven days were detected and oxygen partial pressure in wound tissue fluid were measured after treated for seven days.The clinical efficacy was evaluated by ulceration area of the wound and the changes of purulent secretion.Results　There was no statistically significant difference in the oxygen partial pressure in wound tissue fluid,the activity of LDH and SDH,ulceration area between the two groups before treatment(P>0.05).After treated for seven days，the oxygen partial pressure in wound tissue fluid in the observation group（111.99±3.75）mmHg（1 mmHg=0.133 kPa）was higher than that in the control group（42.99±4.14）mmHg（P<0.05）.Compared with that before treatment，the activity of LDH decreased more significantly while the activity of SDH increased more significantly in the two groups after treated for seven days（P<0.05）.After treated for seven days，the activity of LDH in granulation tissue of wound in the observation group was lower while the activity of SDH was higher，and the improve conditions of ulceration area and purulent secretion were better than those in the control group（P<0.01，P<0.05）.The therapeutic effective rate in the observation group（90.5%）was higher than that in the control group（71.4%）（χ²=18.640,P<0.05）.Conclusion　The combination of VSD and TOT can promote the repairing of chronic wound of diabetic foot，improve the clinical curative effect.The mechanism maybe involve in improving the oxygen partial pressure and LDH activity of the wound tissue，and reducing the SDH activity.

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更新日期/Last Update: 2017-05-05