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作 者:朱晓晴[1] 丁敏[1] 徐俊[1] 孙卉[1] 马亚楠[1] 王鹏华[2]
机构地区:[1]天津医科大学代谢病医院内分泌研究所,卫生部激素与发育重点实验室,天津市代谢性疾病重点实验室,天津300070 [2]天津医科大学代谢病医院糖尿病足科,天津300070
出 处:《临床荟萃》2016年第12期1302-1307,共6页Clinical Focus
基 金:天津市科学技术委员会(10JCZDJC19800);天津市卫生局科技基金(2015KZ092)
摘 要:目的比较糖尿病足感染(diabetic foot infection,DFI)患者在标准治疗基础上,局部应用莫西沙星对创面感染的控制、细菌耐药性以及愈合的影响。方法选择我院住院的DFI患者110例,随机分为对照组和观察组,各55例。再根据踝肱指数分为2个亚组,非缺血组和缺血组。标准治疗基础上,观察组加用盐酸莫西沙星浸润的可吸收性明胶海绵治疗。第0、14、28天,测定感染相关指标、细菌培养及药敏试验、测定创面面积并计算临床总有效率。结果第14、28天,观察组感染相关指标下降、溃疡面积缩小及临床总有效率方面优于对照组(P<0.05),且细菌耐药性未见增加(P>0.05);缺血的观察组感染相关指标下降、溃疡面积缩小及临床总有效率提高方面优于对照组(P<0.05),非缺血组间差异无统计学意义(P>0.05)。结论缺血的DFI患者全身抗生素联合创面局部莫西沙星治疗,可有效控制感染并促进创面愈合,且不增加耐药性。Objective To observe the control of wound infection,drug resistance and wound healing in topical antibiotics combined with systemic antibiotics therapy for treating diabetic foot infection(DFI).Methods One hundred and ten hospitallized patients with DFI in our hospital were selected,then the patients were randomly divided into two subgroups,control group and observation group,each group 55 cases.According to ankle-brachial index,each group was divided into two subgroups,non-ischemic group and ischemia group.All patients accepted norms of diabetic foot infection therapy,patients in experimental group using moxifloxacin hydrochloride's absorbability gelatin sponge treatment.At days of 0,14,28,blood samples were collected to test infection-related indicators,bacterial culture and sensitivity test,measuring of wound area and calculate the total efficiency.Results At 14 and 28days,the infectionrelated indicators in observation group were decreased,wounds size reduction and total clinical efficiency were better than those of control group(P 0.05).Antibiotic bacterial resistance were not increased(P 0.05);For ischemia group in observation group,the infection-related indicators were decreased,wounds size reduction and total clinical efficiency were better than those of control group(P 0.05),but in the non-ischemic group,they showed no significant difference(P 0.05).Conclusion Topical application seems safe,can control infection and promote wound healing when combined with systemic antibiotics therapy in DFI patients with ischemia.
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