负压创面治疗对糖尿病足溃疡的疗效观察  

Outcome of negative pressure wound therapy on diabetic foot ulcers： an observational study

作　　者：何芳[1] 朱慧娟[2] 董颖越[1] 赵艳伟[3] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内分泌科,100730 [2]空军总医院内分泌科 [3]中国医学科学院北京协和医学院北京协和医院内科,100730

出　　处：《中华医学杂志》2017年第32期2525-2527,共3页National Medical Journal of China

摘　　要：目的比较负压创面治疗组及常规治疗组对糖尿病足溃疡治疗3个月的疗效。方法收集北京协和医院内分泌科及空军总医院内分泌科2015年1月1日至2016年12月31日住院期间行负压引流治疗的糖尿病足患者作为试验组，并收集同时期按照性别、年龄、糖尿病病史、糖化血红蛋白水平和糖尿病足病变范围进行1：1比例匹配的采用常规治疗的患者作为对照组。以创面完全愈合或好转，创面没有明显分泌物，坏死组织大部分脱落并且有新生肉芽为有效。无效：坏疽创面无缩小、分泌物无减少、坏疽局部无明显变化或恶化者为无效。两者差别使用Х^2检验进行统计学分析。结果试验组和对照组均有31例纳入研究，3个月后试验组有效26例，5例疗效不佳，4例采用外科手术治疗；对照组有18例有效，13例疗效不佳，6例采用外科手术治疗。试验组较对照组有效率高，差异有统计学意义（P〈0．05）。结论负压创面治疗可有效改善糖尿病足溃疡3个月的愈合。Objective To compare the treatment effects between negative pressure wound therapy （NPWT） and traditional therapy in diabetic patients with foot ulcers. Methods Diabetic patients with foot ulcers were selected from Endocrinology Ward between January 2015 and December 2016. All the patients were consecutively selected to receive NPWT in addition to the traditional therapy. Each patient receiving NPWT was individually matched with a patient receiving only traditional therapy and selected as the control group. Patients were controlled in both groups for age, sex and history of diabetes, hemoglobin Alc （HbAlc） level, and severity of the ulcer. Each patient received therapy for 3 months and was evaluated at the end of treatment. Treatment efficacy was evaluated by examining the lesion area before and after the therapy. Outcomes were compared between the two groups using the Chi square test. Results A total of 62 patients were included in the study, with 31 cases in each group. Three months later, in the NPWT group, 26 patients had good therapeutic effects, 5 patients had poor efficacy, and 4 patients underwent the surgical treatment. While in the control group, only 18 patients had good therapeutic effects, 13 patients had poor efficacy, and 6 patients underwent surgical treatment. The effective percentage was significantly higher in NPWT group than that of the control group （P 〈 0. 05）. Conclusion NPWT can effectively improve the healing process of patients with diabetic foot ulcers in 3 months.

关 键 词：负压创面治疗 糖尿病足 护理治疗 糖尿病教育 

分 类 号：R587.2[医药卫生—内分泌]