双套管冲洗负压吸引技术在Ⅲ级糖尿病足患者伤口的应用  

Application of dual cannula continuous douche by negative pressure drainage in patients with diabetic foot wounds grade Ⅲ

作　　者：蔡秋妮[1] 李昭辉[1] 郭娇娇[1] 

机构地区：[1]厦门大学附属中山医院血管外科,361003

出　　处：《中华糖尿病杂志》2013年第10期630-633,共4页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的了解双套管冲洗负压吸引技术在Ⅲ级糖尿病足患者中应用的可行性。方法2011年1月至2012年2月，选取在我科住院确诊的Ⅲ级糖尿病足患者（均为单足）共36例，其中男15例、女21例，按随机数字表法分为试验组17例，年龄（63±8）岁；对照组19例，年龄（65±6）岁。对照组实施脓肿切开引流术后常规换药，试验组实施脓肿切开引流术后置人双套管持续冲洗吸引，至引流液澄清拔除双套管，采用常规换药，观察两组患者创面愈合情况。统计学分析采用卡方检验和t检验。结果试验组17例患者中，14例完全愈合，3例明显好转，治愈率达82．4％。对照组19例有8例治愈，8例好转，治愈率42．1％，差异有统计学意义（x^2=6．12，P〈0．05）。对照组3例经1个月换药等综合治疗后未见明显好转，其中包括2例在治疗期间病情恶化经截肢术处理。试验组患者创面愈合时间（20±3）d，对照组为（29±4）d，差异有统计学意义（t=6．5，P〈0．001）。结论双套管冲洗负压吸引技术可促进Ⅲ级糖尿病足患者伤口的愈合，减轻患者疼痛，并减少截肢的发生。Objective To determine the feasibility of perfusion cannula by continuous douche accompanied with negative pressure drainage applied in patients with diabetic foot complications. Methods Thirty six patients of m grade diabetic foot patients were selected from January 2011 to February 2012, including male 15 and female 21. According to the random number table, 17 cases were divided into the intervention group （ aged （ 63 ± 8 ） yrs） and 19 cases in the control group （ aged （ 65 ± 6 ） yrs ）. The control group received routine dressing after abscess incision. The intervention group received abscess incision drainage and double tube continuous irrigation and suction with negative pressure. When the drainage fluid was clear, the double tubes were removed and changed routine dressing. Wound state of the patients in the two groups were observed and compared. Chi-square test and t test were used for statistical analysis. Results Fourteen cases in intervention group were cured, three cases improved, and the curative rate was 82. 4% （ 14/17 ）. Eight cases in control group were cured, eight cases improved, and the curative rate was 42. 1%. The difference between the two groups was statistically significant （ x2 = 6. 12, P 〈 0. 05 ）. However, three cases in control group had no clear improvement, including two patients were received amputation. The average time of healing was （20 ± 3 ） d in the intervention group and （29 ± 4） d in the control group with statistically significant difference （t = 6. 5, P 〈 0. 001 ）. Conclusion The use of dual cannula continuous douche by negative pressure drainage may improve wound healing, alleviate sufferings, and reduce the amputation rate in patients with diabetic foot wounds grade Ⅲ.

关 键 词：足病 糖尿病 脓肿 负压吸引技术 双套管 

分 类 号：R587.2[医药卫生—内分泌]