银离子敷料联合水凝胶治疗糖尿病足的效果及对相关血清炎症因子的影响  

Effects of silver ion dressing combined with hydrogel therapy on diabetic foot patients and serum inflammatory factors

作　　者：金晓明 韩思佳[2] 吴雁翔[1] JIN Xiao-ming;MAN Si-jia;WU Yan-xiang(Department of Endocrinology,the 463rd Hospital of Chinese PLA,Liaoning Province,Shenyang 110046,China;Department of Breast Surgery,the Affiliated Shengjing Hospital of China Medical University,Liaoning Province,Shenyang 110004,China)

机构地区：[1]中国人民解放军第四六三医院内分泌科,辽宁沈阳110046 [2]中国医科大学附属盛京医院乳腺外科,辽宁沈阳110004

出　　处：《河北医科大学学报》2018年第12期1380-1383,1388,共5页Journal of Hebei Medical University

摘　　要：目的观察银离子敷料联合水凝胶治疗糖尿病足的效果及对相关血清炎症因子的影响。方法收集糖尿病足患者72例,随机分为观察组和对照组各36例。对照组给予湿疗伤口敷料联合水凝胶,观察组给予银离子敷料联合水凝胶。比较2组糖尿病足溃疡清创时间、肉芽组织生长时间、上皮组织形成时间,临床疗效和总有效率,治疗前后下肢动脉病变评分、血管内皮黏附分子1(vascular endothelial adhesion molecule-1,VCAM-1)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)水平。结果观察组清创时间、肉芽组织形成时间和上皮组织形成时间均少于对照组,差异有统计学意义(P<0.05);观察组临床疗效和总有效率均优于或高于对照组(P<0.05);治疗后2组下肢动脉病变评分均低于治疗前,且观察组下肢动脉病变评分低于对照组,差异均有统计学意义(P<0.05);治疗后2组VCAM-1、TNF-α、CRP水平均低于治疗前,差异有统计学意义(P<0.05),治疗后对照组IL-6较治疗前升高,观察组治疗后IL-6较治疗前降低,治疗后观察组VCAM-1、TNF-α、IL-6及CRP水平低于对照组,差异均有统计学意义(P<0.05)。结论银离子敷料联合水凝胶治疗糖尿病足较湿疗伤口敷料可进一步提高患者的临床疗效,改善下肢动脉病变,其作用机制可能与清除血清炎症因子有关。Objective To explore the effects of silver ion dressing combined with hydrogel therapy on patients with diabetic foot and serum inflammatory factors.Methods A total of 72 patients with the diabetic foot were collected and divided into the observation group（n=36）and the control group（n=36）randomly.The control group were given wet wound dressing combined with hydrogel,while the observation group were treated with silver ion dressing combined with hydrogel.The debridement time for diabetic foot ulcers,granulation tissue growth time,epithelial tissue formation time,the curative effects and total effective rate,the lower extremity arterial disease score,vascular endothelial adhesion molecule-1（VCAM-1）,tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）,C reactive protein（CRP）levels of two groups before and after treatment were compared.Results The debridement time,granulation tissue formation time and the granulation tissue growth time in the observation group were lower than the control group（P〈0.05）.The total effective rate of the observation group was 91.7%,which was higher than the control group（72.2%）（P〈0.05）.There was no significant difference between the two groups of the lower extremity arterial disease score before treatment（P〉0.05）.After treatment,the lower extremity arterial disease score of the two groups was lower than pre-treatment（P〈0.05）,and the lower extremity arterial disease score in the observation group was lower than the control group（P〈0.05）.There was no significant difference between two groups in VCAM-1,TNF-α,IL-6 and CRP levels before treatment（P〉0.05）.After treatment,the VCAM-1,TNF-α,IL-6 and CRP levels of the two groups were lower than pre-treatment（P〈0.05）,and the VCAM-1,TNF-α,IL-6 and CRP levels in the observation group were lower than the control group（P〈0.05）.Conclusion Compared with wet wound dressing,silver ion dressing combined with hydrogel therapy on the patients with diabetic foot could improve the cli

关 键 词：糖尿病足 银离子敷料 水凝胶 血清炎症因子 

分 类 号：R587.29[医药卫生—内分泌]