超声清创刀联合负压创面系统治疗糖尿病足溃疡效果及其机制  

Mechanism study of the effect of ultrasound debridement combined with vacuum sealing drainage on diabetic foot ulcer

作　　者：杨帆[1] 杨宁[1] 程天平[1] 李向云[1] 张健[1] 王钊[1] 刘波[1] 郑炜[1] 冯金 郭宏强 YANG Fan;YANG Ning;CHENG Tianping;LI Xiangyun;ZHANG Jian;WANG Zhao;LIU Bo;ZHENG Wei;FENG Jin;GUO Hongqiang(Xingtai People＇s Hospital, Xingtai 054000, Chin)

机构地区：[1]邢台市人民医院,河北邢台054000 [2]郑州大学附属肿瘤医院,郑州450008

出　　处：《实用医学杂志》2018年第8期1239-1243,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81101197);河北省邢台市科技计划项目(编号:2017ZC109)

摘　　要：目的探讨超声清创刀联合负压创面系统治疗糖尿病足溃疡效果及其机制。方法将81例患者随机分为两组,超声清创刀联合负压创面系统为试验组,常规清创联合负压创面系统为对照组,观察治疗后临床疗效、创面缩小率、肉芽覆盖率及细菌清除率、血流情况,测定组织中HIF-1α与VEGF的表达。结果试验组临床疗效明显优于对照组(P<0.05),创面缩小率、肉芽覆盖率明显高于对照组(P<0.05),治疗后14 d,试验组血流灌注明显高于对照组(P<0.05),并且试验组溃疡组织中HIF-1α与VEGF的表达明显高于对照组(P<0.05)。结论超声清创刀联合负压创面可以提高临床疗效、创面缩小率、肉芽覆盖率及细菌清除率,增加溃疡组织血流,其可能机制为增加溃疡组织中HIF-1α及VEGF的表达而实现的。Objective To investigate the effect of ultrasound debridement combined with vacuum sealingdrainage on the treatment of diabetic foot ulcer and the potential mechanism. Methods Eighty-one patients withdiabetic ulcer were randomly divided into two groups：ultrasound debridement combined with vacuum sealing drain-age as the experimental group,routine debridement combined with vacuum sealing drainage as the control group.The clinical curative effect,the reduction rate of the wound,the rate of blastocyst and the rate of bacterial clear-ance and blood flow were detected. Results The clinical curative effect in the experimental group was significantlybetter than that in the control group（P〈0.05）. The rates of wound reduction and granulation were significantlyhigher than those in the control group（P〈0.05）. After 14-day treatment,the blood perfusion in the experimentalgroup was significantly higher than that in the control group（P〈0.05）,and the expression of HIF-1α and VEGFin the ulcer tissue was significantly higher than that in the control group（P〈0.05）. Conclusions Ultrasound de-bridement combined with vacuum sealing drainage can improve the clinical efficacy,wound reduction rate,granu-lation coverage rate and bacterial clearance rate,and increase ulcer tissue blood flow. The potential mechanism isrelated with the increases of HIF-1α and VEGF in ulcer tissue.

关 键 词：糖尿病足溃疡 超声清创刀 负压创面系统 HIF-1Α VEGF 

分 类 号：R587.2[医药卫生—内分泌]