自体脂肪干细胞在糖尿病足创面治疗中的应用  

The clinical study of autologous adipose-derived stem cells( ADSCs) therapy in repairing diabetic foot

作　　者：赵月强[1] 朱占永[1] 李爱林[1] 王晓莉 童怡兰[1] 余墨声[1] ZHAO Yueqiang;ZHU Zhanyong;LI Ailin;et al(Department of Plastic Surgery,People＆ Hospital of Wuhan University, Wuhan 430060, Chin)

机构地区：[1]武汉大学人民医院整形外科,430060

出　　处：《临床外科杂志》2018年第1期63-66,共4页Journal of Clinical Surgery

摘　　要：目的探讨自体脂肪干细胞在糖尿病皮肤创面中的修复作用。方法 80例糖尿病足病人按随机、单盲方法分为对照组和干细胞治疗组。干细胞治疗组病人共37例,采用以自体脂肪干细胞局部注射的治疗方法;对照组共43例,采用传统换药为主的治疗方法。干细胞组在治疗过程中根据情况采用植皮术、皮瓣转移等手术方法加速创面愈合。对照组清创后采用传统换药治疗。4周后观察治疗效果,并随访1~6个月。结果所有病人均于首次治疗后获随访,随访时间1~6个月。自体脂肪干细胞治疗组病人在2~3个疗程后,可发现创面明显缩小,坏死组织及脓苔清除,组织色泽健康,血供良好,小的创面可以在治疗后自行愈合。平均治疗4周后,自体脂肪干细胞治疗组创面愈合面积约65.3%,对照组创面愈合面积约32.1%,两者对比差异具有统计学意义(P<0.05);干细胞组创面感染率约8.4%,对照组创面感染率约20.3%,差异具有统计意义(P<0.05);干细胞组平均住院时间(42.5±2.6)天,对照组平均住院时间(57.2±2.1)天,两组对比差异具有统计意义(P<0.05)。两组病人足背Tc PO2值测定显示:干细胞治疗组的足背经皮氧分压值,由术前的(33.28±6.48)mmol/L上升到术后的(41.88±7.89)mmol/L,干细胞组术前术后相比,差异具有统计意义(P<0.05);而对照组的足背经皮氧分压值,由术前的(34.15±6.25)mmol/L变为术后的(37.58±7.65)mmol/L,本组术前术后相比,两者差异无统计学意义(P>0.05)。结论脂肪干细胞不仅可以加速糖尿病足皮肤创面愈合,还可以通过释放多种细胞因子促进血管生成,从而改善患肢的血供达到较好的治疗效果。Objective To study the effect of adult adipose-derived stem cells（ ADSCs） on repairing diabetic foot. Methods A total of 80 patients were enrolled according to the criteria of inclusion and exclusion in our study from November 2015 to November 2016,and were randomly divided into control group and stem cell therapy group by single blind. Patients in stem cell therapy group（ 37 cases） were locally injected with autologous adipose stem cells,and patients in control group（ 43 cases） were treated with traditional dressing. Skin graft and flap transplantation were used in some patients with big skin ulcer in stem cell therapy group. To the control group,dress changing and drainage were applied for 4 weeks. The therapeutic effect of the two groups were evaluated after 4 weeks,and followed up for 1 ~ 6 months. Results After 2 ~ 3 times of treatment,wound surface reduction,clear necrotic tissue and clear pus moss,healthy tissue color,good blood supply and small wound self-healing were found in the patients with autologous adipose stem cell therapy. After an average 4-weeks＇ treatment,the percentage of wound healing area of autologous adipose stem cell group was about 65. 3% and that of control group was about 32. 1%,the difference between two groups was statistically significant（ P〈0. 05）; the wound infection rate of autologous adipose stem cell group was about 8. 4% and that of control group was about 20. 3%,the difference between two groups was statistically significant（ P〈0. 05）; the average hospitalization days of autologous adipose stem cell group was（ 42. 5 ± 2. 6） days and that of control group was（ 57. 2 ± 2. 1） days,the difference between two groups was statistically significant（ P〈0. 05）. The dorsal foot Tc PO2 value of autologous adipose stem cell group was（ 33. 28 ± 6. 48） mmol/L before operation and（ 41. 88 ± 7） mmol/L after operation,the difference was statistically significant（ P〈0. 05）. While the dorsal foot Tc PO2 value of control group was（ 34.

关 键 词：脂肪干细胞 糖尿病足 创面 修复 

分 类 号：R587.2[医药卫生—内分泌]