创面持续负压吸引联合植皮术治疗糖尿病足溃疡的临床效果研究
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摘要
目的探究创面持续负压吸引联合植皮术在治疗糖尿病足溃疡的临床效果。方法随机抽取2017年1月～2018年5月在本院进行糖尿病足溃疡治疗的90例患者。并根据治疗方式的不同将其分为传统组与持续负压吸引(VSD)+植皮术组,每组各45例,即两组患者分别采用常规换药、清创治疗与创面持续负压吸引联合植皮术治疗。比较两组患者创面溃疡愈合时间、愈合率、植皮时机、医疗费用、VAS评分以及手术次数。结果 VSD+植皮术组创面溃疡愈合时间、愈合率、植皮时机短于传统组,医疗费用少于传统组,差异有统计学意义(P <0.05);VSD+植皮术组VAS评分明显低于传统组(2.10±0.50)分vs (4.26±1.37)分,差异有统计学意义(P <0.05);VSD+植皮术组仅有2例(4.44%)患者需再次治疗,低于传统组的12例(26.67%),差异无统计学意义(P> 0.05)。术后3个月观察组复发0例,对照组复发4例(8.89%),两组复发率比较差异有统计学意义(P <0.05)。结论创面持续负压吸引联合植皮术具有更高安全性,可提高糖尿病足溃疡临床疗效,加快患者溃疡愈合速度,减轻医疗经济负担,故更有临床推广与应用价值。
Objective To explore the clinical effect of wound continuous negative pressure aspiration and skin grafting on treating diabetic foot ulcer. Methods Ninety patients with diabetic foot ulcer treated in our hospital from January 2017 to May 2018 were randomly selected and divided into the traditional group and the continuous negative pressure aspiration(VSD)combined with skin grafting group(n=45)according to different treatment methods.The traditional group was treated with conventional dressing change and debridement therapy,and the VSD combined with skin grafting group was treated with continuous negative pressure aspiration combined with skin grafting.The wound ulcer healing time,healing rate,skin grafting time,medical cost,VAS score and number of operations of the two groups were compared. Results The wound ulcer healing time,healing rate and skin grafting time in the VSD combined with skin grafting group were shorter than those in the traditional group,and the medical cost was less than that in the traditional group,the difference was statistically significant(P < 0.05).VAS score of the VSD combined with skin grafting group was(2.10±0.50),significantly lower than that of the traditional group(4.26+1.37),and the difference was significant(P < 0.05).There were only 2 patients(4.44%)in the VSD combined with skin grafting group needed reoperation,lower than of 12 patients(26.67%)in the traditional group,with no statistically significant difference(P >0.05).There were no recurrences in the observation group and 4 recurrences in the control group(8.89%)3 months after operation,and the difference of recurrence rate was statistically significant(P < 0.05). Conclusion wound continuous negative pressure aspiration and skin grafting operation has higher safety,which can improve the clinical efficacy of diabetic foot ulcer,accelerate the healing of patients' ulcer,and reduce the medical and economic burden.
Objective To explore the clinical effect of wound continuous negative pressure aspiration and skin grafting on treating diabetic foot ulcer. Methods Ninety patients with diabetic foot ulcer treated in our hospital from January 2017 to May 2018 were randomly selected and divided into the traditional group and the continuous negative pressure aspiration(VSD)combined with skin grafting group(n=45)according to different treatment methods.The traditional group was treated with conventional dressing change and debridement therapy,and the VSD combined with skin grafting group was treated with continuous negative pressure aspiration combined with skin grafting.The wound ulcer healing time,healing rate,skin grafting time,medical cost,VAS score and number of operations of the two groups were compared. Results The wound ulcer healing time,healing rate and skin grafting time in the VSD combined with skin grafting group were shorter than those in the traditional group,and the medical cost was less than that in the traditional group,the difference was statistically significant(P < 0.05).VAS score of the VSD combined with skin grafting group was(2.10±0.50),significantly lower than that of the traditional group(4.26+1.37),and the difference was significant(P < 0.05).There were only 2 patients(4.44%)in the VSD combined with skin grafting group needed reoperation,lower than of 12 patients(26.67%)in the traditional group,with no statistically significant difference(P >0.05).There were no recurrences in the observation group and 4 recurrences in the control group(8.89%)3 months after operation,and the difference of recurrence rate was statistically significant(P < 0.05). Conclusion wound continuous negative pressure aspiration and skin grafting operation has higher safety,which can improve the clinical efficacy of diabetic foot ulcer,accelerate the healing of patients' ulcer,and reduce the medical and economic burden.
引文
[1]卫东,杜丽萍,张家建.封闭负压引流联合生物敷料对糖尿病足溃疡创面植皮后血管新生、炎症反应的影响[J].海南医学院学报,2017,23(15):2071-2074.
[2]刘岩,徐英华,耿艳侠,等.VSD联合游离皮片植皮治疗糖尿病足感染的应用效果研究[J].河北医学,2016,22(6):991-993.
[3]李日绍,余东,关术,等.真空负压引流技术联合人工真皮治疗糖尿病足的效果[J].广东医学,2016,37(14):2114-2115.
[4]卫东,杜丽萍,张家建.封闭负压引流联合生物敷料对糖尿病足溃疡创面植皮后血管新生、炎症反应的影响[J].海南医学院学报,2017,23(15):2071-2074.
[5]耿艳侠,卢思英,刘岩.封闭负压引流技术联合游离皮片植皮在糖尿病足感染创面的应用研究[J].重庆医学,2016,45(9):1260-1262.
[6]刘小龙,苏福增,查天建,等.糖尿病足溃疡403例的修复体会[J].中华损伤与修复杂志:电子版,2017,12(4):269-273.
[7]耿艳侠,卢思英,刘岩.封闭负压引流技术联合游离皮片植皮在糖尿病足感染创面的应用研究[J].重庆医学,2016,45(9):1260-1262.
[8]张磊,曹东升,谢娟,等.负压封闭引流治疗糖尿病足效果评价[J].安徽医学,2016,37(5):517-521.
[9]朱琳怡,傅育红,莫兰.封闭负压引流联合局部间歇给氧对糖尿病足的临床疗效观察[J].护士进修杂志,2017,32(20):1890-1893.
[10]姚建华.封闭负压引流技术治疗糖尿病足的效果观察[J].中国综合临床,2017,33(1):30-33.
[11]徐铌,麦梨芳,李永洁,等.不同部位糖尿病足溃疡愈合情况分析[J].护理学杂志,2017,32(3):12-14.
[12]徐成,鲁延林,范锟铻.负压封闭引流在糖尿病足治疗中的应用研究[J].中国临床研究,2016,29(5):627-628.
[13]余文林,张斌,李勤.糖尿病足的创面修复156例[J].实用医学杂志,2017,33(3):399-401.
[14]李民仕,黄道强.糖尿病足选择植皮手术联合负压创面治疗的临床分析[J].糖尿病新世界,2016,19(20):99-100.
[15]郑光辉,杨娟,曾朝涛,等.封闭式负压引流联合点状植皮在糖尿病足溃疡治疗中的临床应用[J].岭南现代临床外科,2017,17(5):601-603.
[2]刘岩,徐英华,耿艳侠,等.VSD联合游离皮片植皮治疗糖尿病足感染的应用效果研究[J].河北医学,2016,22(6):991-993.
[3]李日绍,余东,关术,等.真空负压引流技术联合人工真皮治疗糖尿病足的效果[J].广东医学,2016,37(14):2114-2115.
[4]卫东,杜丽萍,张家建.封闭负压引流联合生物敷料对糖尿病足溃疡创面植皮后血管新生、炎症反应的影响[J].海南医学院学报,2017,23(15):2071-2074.
[5]耿艳侠,卢思英,刘岩.封闭负压引流技术联合游离皮片植皮在糖尿病足感染创面的应用研究[J].重庆医学,2016,45(9):1260-1262.
[6]刘小龙,苏福增,查天建,等.糖尿病足溃疡403例的修复体会[J].中华损伤与修复杂志:电子版,2017,12(4):269-273.
[7]耿艳侠,卢思英,刘岩.封闭负压引流技术联合游离皮片植皮在糖尿病足感染创面的应用研究[J].重庆医学,2016,45(9):1260-1262.
[8]张磊,曹东升,谢娟,等.负压封闭引流治疗糖尿病足效果评价[J].安徽医学,2016,37(5):517-521.
[9]朱琳怡,傅育红,莫兰.封闭负压引流联合局部间歇给氧对糖尿病足的临床疗效观察[J].护士进修杂志,2017,32(20):1890-1893.
[10]姚建华.封闭负压引流技术治疗糖尿病足的效果观察[J].中国综合临床,2017,33(1):30-33.
[11]徐铌,麦梨芳,李永洁,等.不同部位糖尿病足溃疡愈合情况分析[J].护理学杂志,2017,32(3):12-14.
[12]徐成,鲁延林,范锟铻.负压封闭引流在糖尿病足治疗中的应用研究[J].中国临床研究,2016,29(5):627-628.
[13]余文林,张斌,李勤.糖尿病足的创面修复156例[J].实用医学杂志,2017,33(3):399-401.
[14]李民仕,黄道强.糖尿病足选择植皮手术联合负压创面治疗的临床分析[J].糖尿病新世界,2016,19(20):99-100.
[15]郑光辉,杨娟,曾朝涛,等.封闭式负压引流联合点状植皮在糖尿病足溃疡治疗中的临床应用[J].岭南现代临床外科,2017,17(5):601-603.