摘要
(1)目的探讨改良负压封闭引流(VSD)技术联合医用几丁糖治疗糖尿病足感染创面的临床疗效,为糖尿病足感染的治疗提供更加合理有效的方案。(2)方法选取2015年12月～2017年12月就诊于唐山工人医院的糖尿病足Wagner分级3～5级的患者57例为研究对象,采用随机分组方法分为对照组(27例)和观察组(30例)。所有患者入院后给予积极控制血糖及抗感染等综合治疗,完全清除病足表面坏死组织。对照组采用普通VSD技术,观察组采用改良VSD技术联合医用几丁糖治疗方案,即在普通VSD装置基础上增加一根输液管作为冲洗管,每日固定时间经冲洗管注入无菌生理盐水500mL和医用几丁糖30mL,治疗10天后拆除VSD装置,开放创面,对比两组治疗治疗效果。(3)结果观察组肉芽组织生长评分(2.90±0.40)分,对照组(2.14±0.76)分,两组比较差异有统计学意义(P <0.05);观察组引流管堵塞率为6.70%、创面感染率为0、创面愈合时间为(20.66±5.17)天、住院时间为(28.30±3.89)天;对照组分别为29.60%、22.20%、(40.00±7.92)天和(49.22±6.00)天,两组比较差异均有统计学意义(P <0.05)。(4)结论采用改良VSD技术联合医用几丁糖是治疗糖尿病足的有效方法,尤其在促进创面肉芽组织生长、缩短创面愈合时间及住院时间、降低创面感染率及引流管堵塞率等方面相较于对照组有显著的提高。
Objective To explore the clinical effect of modified negative pressure closed drainage technique(VSD)combined with medical chitosan in the treatment of diabetic foot infection,and to provide a more reasonable and effective solution for the treatment of diabetic foot infection.Methods A total of 57 patients during the period of diabetic foot with Wagner class 3~5 were selected from December 2015 to December 2017 in Tangshan Gongren Hospital,by random grouping method was divided into control group(n=27)and observation group(n=30).All patients admitted to hospital after a positive control blood sugar and comprehensive treatment measures,such as resistance to infection in patients with disease completely cleared surface after the necrotic tissue,the control group with common VSD technique treatment,the observation group improved the VSD technology combined chitosan treatment scheme,which based on ordinary VSD devices increase a iv as flushing tube,and in the daily fixed time by the flushing tube injection of sterile saline 500mL/d,medical chitosan 30mL/d,and in the treatment of 10 days after dismantling the VSD devices,open wounds.The effects of treatment were compared between the two groups.Results The granulation tissue growth rating(2.90±0.40)points in observation group was significantly higher than the control group(2.14±0.76),P<0.05,the observation group of drainage tube plugging(6.70%),wound infection rate(0.00%),wound healing time(20.66±5.17)days and hospitalization time(28.30±3.89)days significantly lower than the control group 29.60%,22.20%,(40.00±7.92),(49.22±6.00),P<0.05.Conclusion Modified VSD technique combined chitosan is one of the effective method of treatment of diabetic foot,especially in the promote wound granulation tissue growth,shorten the healing time and hospital stay,reduce the infection of the wound and plugging rate compared with the control group,there is a significant increase,it worthy of clinical application.
作者
谭孟荣
张义庚
王帅
孙书宏
刘宁
李春光
TAN Mengrong;ZHANG Yigeng;WANG Shuai;SUN Shuhong;LIU Ning;LI Chunguang(Tangshan Gongren Hospital,Tangshan 063000,China)
出处
《华北理工大学学报（医学版）》
2018年第6期453-458,共6页
Journal of North China University of Science and Technology：Health Sciences Edition
关键词
负压封闭引流
糖尿病足
感染
医用几丁糖
Closed negative pressure drainage
Diabetic foot
Infection
Medical chitosan
