美兰活体组织染色在糖尿病足精准清创中的可行性研究
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摘要
目的:评价美兰染色精确定位糖尿病足失活组织清创范围的效果及清创操作者的接受程度。方法:将40例糖尿病足患者随机分为5组,根据清创方式的不同分为对照组(传统清创方式)、美兰精准清创1组(美兰浓度为0.01mg/ml)、美兰精准清创2组(美兰浓度为0.05mg/ml)、美兰精准清创3组(美兰浓度为0.1mg/ml)、美兰精准清创4组(美兰浓度为0.15mg/ml),并在规定时间点测量清创面积和5天后坏死组织面积发生率,以及两种清创方法清创操作者的接受程度。结果:美兰精准清创1～3组在清创面积和5天后坏死组织面积发生率均优于对照组均(P<0.01或0.05),特别是美兰浓度为0.05mg/ml的精准清创2组。5位清创操作者均表示在今后的工作中更愿意选择美兰精准清创方式。结论:美兰染色能快速定位糖尿病足创面需清创失活组织。
Objective To evaluate the intervention effects and acceptability of methylene blue staining in precise debridement of diabetic foot.Methods 40 cases of diabetic foot were randomly divided into control group(traditional debridement methods), methylene blue precise debridement group 1(0.01 mg/ml), methylene blue precise debridement group 2(0.05 mg/ml), methylene blue precise debridement group 3(0.1 mg/ml) and methylene blue precise debridement group 4(0.15 mg/ml) according to different debridement method for wound.Debridement area,incidence of necrotic tissue area after 5 days and acceptability were observed at specified time points.Results The debridement area and ncidence of necrotic tissue area after 5 days in methylene blue precise debridement group 1～3 were significantly better than control group. 5 operator received methylene blue precise debridement. Conclusion methylene blue staining can quickly locate the deactivated tissue that needs debridement in the wound of diabetic foot.
Objective To evaluate the intervention effects and acceptability of methylene blue staining in precise debridement of diabetic foot.Methods 40 cases of diabetic foot were randomly divided into control group(traditional debridement methods), methylene blue precise debridement group 1(0.01 mg/ml), methylene blue precise debridement group 2(0.05 mg/ml), methylene blue precise debridement group 3(0.1 mg/ml) and methylene blue precise debridement group 4(0.15 mg/ml) according to different debridement method for wound.Debridement area,incidence of necrotic tissue area after 5 days and acceptability were observed at specified time points.Results The debridement area and ncidence of necrotic tissue area after 5 days in methylene blue precise debridement group 1～3 were significantly better than control group. 5 operator received methylene blue precise debridement. Conclusion methylene blue staining can quickly locate the deactivated tissue that needs debridement in the wound of diabetic foot.
引文
[1]国际血管联盟中国分会糖尿病足专业委员会.糖尿病足诊治指南[J].介入放射学杂志,2013,22(9):705-708.
[2]ARMSTRONG D G,LAVERY L A,Nixon B P,et al.It’s Not What You Put on,but What You Take off:Techniques for Debriding and off-Loading the Diabetic Foot Wound[J].Clin Infect Dis,2004,39(Suppl 2):92-99.
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[4]唐娇,胡细玲,杨玉堂,等.基于国际糖尿病足工作组风险分级系统评估增加糖尿病足风险的影响因素[J].解放军护理杂志,2018,35(01):53-56,61.
[5]张小路.MCP-1及8-iso-PGF2α与糖尿病足病的相关性分析[D].唐山:华北理工大学,2017.
[6]STEED DL,DONOHOE D,WEBSTER MW,et al.Effect of extensive debridement and treatment on the healing of diabetic foot ulcers.Diabetic Ulcer Study Group[J].J Am Coll surg,1996,183(01):61-4.
[7]熊发明.封闭负压引流结合有限清创在肢体软组织爆炸伤早期救治中应用的实验研究[D],甘肃:兰州大学,2010.
[2]ARMSTRONG D G,LAVERY L A,Nixon B P,et al.It’s Not What You Put on,but What You Take off:Techniques for Debriding and off-Loading the Diabetic Foot Wound[J].Clin Infect Dis,2004,39(Suppl 2):92-99.
[3]WAGNER FW JR.THE DYSVASCULAR foot:a system for diagnosis and treatment[J].Foot Ankle,1981,2:64-122.
[4]唐娇,胡细玲,杨玉堂,等.基于国际糖尿病足工作组风险分级系统评估增加糖尿病足风险的影响因素[J].解放军护理杂志,2018,35(01):53-56,61.
[5]张小路.MCP-1及8-iso-PGF2α与糖尿病足病的相关性分析[D].唐山:华北理工大学,2017.
[6]STEED DL,DONOHOE D,WEBSTER MW,et al.Effect of extensive debridement and treatment on the healing of diabetic foot ulcers.Diabetic Ulcer Study Group[J].J Am Coll surg,1996,183(01):61-4.
[7]熊发明.封闭负压引流结合有限清创在肢体软组织爆炸伤早期救治中应用的实验研究[D],甘肃:兰州大学,2010.