超声清创术联合中药灌洗负压技术治疗湿热型糖尿病足创面的临床观察
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摘要
目的观察超声清创术联合中药(解毒洗剂)灌洗负压技术治疗湿热型糖尿病足创面的临床疗效。方法采用随机数字表法将58例住院的湿热型糖尿病足患者,分为观察组30例和对照组28例。观察组应用超声清创术联合中药(解毒洗剂)灌洗负压技术治疗,对照组应用超声清创术联合中药(解毒洗剂)常规换药治疗。比较2组患者的临床疗效,创面面积变化,创面症状体征(肉芽组织颜色及形态、气味、分泌物、创周红肿、疼痛)积分变化以及炎性指标(CRP、WBC、NE%)积分的变化情况。结果 2组的有效率对比,差异有统计学意义(P<0.05);观察组治疗后的症状体征积分、创面面积及炎性指标均低于对照组治疗后(P<0.05);且2组患者均未见明显不良反应。结论超声清创术联合中药灌洗负压技术对湿热型糖尿病足创面的愈合有较好的促进作用,可明显促进肉芽组织生长、减轻异味、减少分泌物、减轻创周红肿及缓解疼痛,值得临床推广及应用。
Objective To observe the clinical efficacy of ultrasonic deb ridement combined with traditional Chinese medicine detoxification lotion lavage negative pressure technique in the treatment of dampness-heat diabetic foot wounds. Methods A total of 58 patients with diabetic foot admitted to the hospital were enrolled in the study and randomly divided into two groups, with 30 in the observation group and 28 in the control group. The observation group was treated with ultrasonic debridement combined with traditional Chinese medicine(detoxification lotion) and negative pressure technique. The control group was treated with ultrasonic debridement combined with conventional Chinese medicine detoxification lotion gauze dressing and application. The effective rate of the two groups of patients, changes in wound area, changes in wound symptoms and signs(granulation tissue color and morphology,secretions, odor, pain, peri-inflammation), and changes in inflammatory markers(CRP, WBC, NE%) were observed. Results The effective rate of the two groups was statistically significant( P <0.05). The scores of the symptoms or signs, wound area and inflammatory indexes of the observation group were lower than those of the control group( P<0.05). No significant adverse reactions were observed in either group. Conclusion Ultrasonic debridement combined with Chinese medicine lavage negative pressure technology can promote the healing of dampness-heat type diabetic foot wounds, which can promote the growth of granulation tissue,reduce pus, relieve pain, reduce odor and redness and reduce infection. It is worthy of clinical promotion and application.
Objective To observe the clinical efficacy of ultrasonic deb ridement combined with traditional Chinese medicine detoxification lotion lavage negative pressure technique in the treatment of dampness-heat diabetic foot wounds. Methods A total of 58 patients with diabetic foot admitted to the hospital were enrolled in the study and randomly divided into two groups, with 30 in the observation group and 28 in the control group. The observation group was treated with ultrasonic debridement combined with traditional Chinese medicine(detoxification lotion) and negative pressure technique. The control group was treated with ultrasonic debridement combined with conventional Chinese medicine detoxification lotion gauze dressing and application. The effective rate of the two groups of patients, changes in wound area, changes in wound symptoms and signs(granulation tissue color and morphology,secretions, odor, pain, peri-inflammation), and changes in inflammatory markers(CRP, WBC, NE%) were observed. Results The effective rate of the two groups was statistically significant( P <0.05). The scores of the symptoms or signs, wound area and inflammatory indexes of the observation group were lower than those of the control group( P<0.05). No significant adverse reactions were observed in either group. Conclusion Ultrasonic debridement combined with Chinese medicine lavage negative pressure technology can promote the healing of dampness-heat type diabetic foot wounds, which can promote the growth of granulation tissue,reduce pus, relieve pain, reduce odor and redness and reduce infection. It is worthy of clinical promotion and application.
引文
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[9]中国医疗保健国际交流促进会糖尿病足病分会.中国糖尿病足诊治指南[J].中华医学杂志,2017,97(4):252.
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[12]中华中医药学会糖尿病足分会.糖尿病足中医诊疗标准[S].世界中西医结合杂志,2011,6(7):618.
[13]蒋米尔,张培华.临床血管外科学[M].北京:科学出版社,2014:298.
[14]陈伟彬,聂运修.超声清创术联合负压封闭引流技术治疗糖尿病足溃疡效果分析[J].白求恩医学杂志,2017,15(2):243-244.
[15]何敏,郑焱玲,邓武权,等.超声清创刀联合负压创面系统治疗糖尿病足溃疡的疗效观察[J].局解手术学杂志,2015,24(1):1-3.
[2]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017版)[J].中华糖尿病杂志,2018,38(4):292-344.
[3]中国医疗保健国际交流促进会糖尿病足分会.中医糖尿病足诊治指南[J].中华医学杂志,2017,97(4):251-257.
[4]李彦辉,张嘉熙,宋少华,等.超声清创刀联合负压创面治疗糖尿病足溃疡的临床效果[J].重庆医学,2016,45(35):4986-4988.
[5] Jiang Y,Wang X,Xia L,et al. A cohort study of diabetic patients and diabetic foot ulceration patients in China[J]. Wound Repair Regan,2015,23(2):222-230.
[6]中国微循环学会周围血管疾病专业委员会糖尿病足学组.糖尿病足创面修复专家共识[J].中华糖尿病杂志,2018:10(5):305-309.
[7]国家中医药管理局医政司.中医病证诊断疗效标准(2018版)[S].北京:中国中医药出版社,2018:143-144.
[8]中华中医药学会外科分会.糖尿病足溃疡中医循证实践指南[J].中国中西医结合外科杂志,2015,21(5):540-543.
[9]中国医疗保健国际交流促进会糖尿病足病分会.中国糖尿病足诊治指南[J].中华医学杂志,2017,97(4):252.
[10]孙晓芳,谢挺.创面是否可以用水清洗[J].创伤外科杂志,2016,18(3):134.
[11]李曰庆.中医外科学[M].北京:中国中医药出版社,2007:19-26.
[12]中华中医药学会糖尿病足分会.糖尿病足中医诊疗标准[S].世界中西医结合杂志,2011,6(7):618.
[13]蒋米尔,张培华.临床血管外科学[M].北京:科学出版社,2014:298.
[14]陈伟彬,聂运修.超声清创术联合负压封闭引流技术治疗糖尿病足溃疡效果分析[J].白求恩医学杂志,2017,15(2):243-244.
[15]何敏,郑焱玲,邓武权,等.超声清创刀联合负压创面系统治疗糖尿病足溃疡的疗效观察[J].局解手术学杂志,2015,24(1):1-3.