负压封闭引流联合新鲜冰冻血浆灌注治疗糖尿病足溃疡  

Clinical Research of Vacuum Sealing Drainage Combined with Fresh Frozen Plasma Perfusion in Diabetic Foot Ulcers

作　　者：成路[1] 王媚 郑建锋[1] 刘奇[1] 宋知仁[1] 

机构地区：[1]解放军169医院烧伤整形科,湖南衡阳421002

出　　处：《华南国防医学杂志》2017年第10期676-678,共3页Military Medical Journal of South China

摘　　要：目的观察负压封闭引流(vacuum sealing drainage,VSD)联合新鲜冰冻血浆(fresh frozen plasma,FFP)灌注治疗糖尿病足溃疡的临床疗效。方法收集2014-08/2016-07月解放军169医院烧伤整形科收治的糖尿病足溃疡(Wagner分级为Ⅱ~Ⅳ级)患者32例。所有患者均常规进行手术清创。术后采用随机数字表法将患者分为两组:VSD组(n=16)和VSD+FFP组(n=16)。待创面床准备完毕后采用游离薄中厚皮片移植术封闭创面。观察两组治疗后创面床准备时间,创面愈合时间,治疗10d后细菌清除率,移植皮片存活率。结果 32例患者糖尿病足溃疡均全部愈合。VSD+FFP组创面床准备时间及创面愈合时间均短于VSD组,组间比较差异具有统计学意义(P<0.05);VSD+FFP组治疗10 d后细菌清除率及移植皮片存活率均高于VSD组,组间比较差异具有统计学意义(P<0.05)。结论治疗糖尿病足溃疡时,VSD+FFP治疗优于单独应用VSD,能够缩短创面床的准备时间,提高细菌清除率,增加移植皮片存活率,促进创面愈合,值得进一步研究与临床推广。Objective To investigate the clinical effects of vacuum sealing drainage（VSD）combined with fresh frozen plasma（FFP）perfusion in treatment of diabetic foot ulcers.Methods Thirty-two patients with diabetic foot ulcer（Wagner classification：Ⅱ-Ⅳ）in author＇s hospital from August 2014 to July 2016 were enrolled into this study.All patients all underwent surgical debridement.After the debridement operation,the patients were randomly divided into VSD group（n=16）and VSD combined with FFP perfusion（VSD＋FFP）group（n=16）by random number table.The thin intermediate thickness split skin grafting was given to cover the wound when the wound bed was preparated.The indexes including wound bed preparation time,would healing time,bacteria clearance rate after 10 d and survival rate of skin grafts,were measured between two groups after treatment.Results Thirty-two patients with diabetic foot ulcers were all healed.The wound bed preparation time and would healing time in the VSD＋FFP group were markedly shorter than those in the VSD group（P0.05）.The bacteria clearance rate and survival rate of skin grafts in the VSD＋FFP group were remarkably higher than those in the VSD group（P0.05）.Conclusion The combination of VSD＋FFP perfusion for treating diabetic foot ulcer has obvious advantages over the single VSD.VSD＋FFP perfusion can shorten the wound bed preparation time,improve the bacteria clearance rate,increase the survival rate of skin grafts,and promote the wound healing.It is worthy of further study and clinical expansion.

关 键 词：糖尿病足 负压封闭引流 新鲜冰冻血浆 皮肤移植 

分 类 号：R587.2[医药卫生—内分泌]