腔内介入治疗联合负压封闭引流技术在糖尿病足溃疡合并膝下动脉缺血患者中的应用效果  

Application effect of endovascular interventional therapy combined with vacuum sealing drainage technique in patients with diabetic foot ulcer complicated with inferior knee artery ischemia

作　　者：何源 蹇兆成[2] 王凯[2] 赵凯[2] 孙顺吉[2] He Yuan;Jian Zhaocheng;Wang Kai;Zhao Kai;Sun Shunji(Clinical Medical College,Weifang Medical University,Weifang 261041,Shandong,China;Department of Vascular Intervention,Affiliated Hospital of Weifang Medical University,Weifang 261041,Shandong,China)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261041 [2]潍坊医学院附属医院血管介入科,山东潍坊261041

出　　处：《血管与腔内血管外科杂志》2022年第2期148-153,共6页Journal of Vascular and Endovascular Surgery

基　　金：潍坊市科技发展计划项目(2020YX038)。

摘　　要：目的探讨腔内介入治疗联合负压封闭引流技术(VSD)在糖尿病足溃疡合并膝下动脉缺血患者中的应用效果。方法收集2017年4月至2021年7月潍坊医学院附属医院收治的118例糖尿病足溃疡合并膝下动脉缺血(膝下动脉闭塞1~3支)患者的临床资料,根据治疗方法不同将其分为联合组(n=40)、介入组(n=40)、VSD组(n=38)。联合组行外周血管腔内介入联合VSD治疗,介入组行单纯外周血管腔内介入治疗,VSD组行单纯VSD治疗,所有患者均给予抗感染、控制血糖、改善微循环、控制合并症等常规基础治疗。比较3组患者的伤口床评估系统(WBS)评分及临床疗效。结果术后7、14、30 d,3组患者WBS总分均升高,且联合组WBS总分高于其他两组,差异均有统计学意义(P<0.05);介入组与VSD组各时间点WBS总分比较,差异均无统计学意义(P>0.05)。术后30 d,3组患者的WBS各项评分均高于术前,进一步两两比较,联合组患者黑痂面积、肉芽生长情况、渗出量、水肿程度和粉红色肉芽面积评分均高于其他两组,差异均有统计学意义(P<0.05);介入组与VSD组WBS各项评分比较,差异均无统计学意义(P>0.05)。术后30 d,3组患者总有效率比较,差异有统计学意义(P=0.013);联合组的总有效率高于其他两组(P<0.05),而介入组与VSD组总有效率比较,差异无统计学意义(P>0.05)。结论外周血管腔内介入治疗联合VSD治疗优势互补,可成为糖尿病足溃疡的重要治疗方式之一。Objective To investigate the application effect of endovascular interventional therapy combined with vacuum sealing drainage(VSD)technique in patients with diabetic foot ulcers complicated with inferior knee artery ischemia.Method The clinical data of 118 patients with diabetic foot ulcer complicated with inferior knee artery ischemia(1-3 branches of inferior knee artery occlusion)treated in the Affiliated Hospital of Weifang Medical University from April 2017 to July 2021 were collected.They were divided into the combination group(n=40),intervention group(n=40),and VSD group(n=38)according to different treatment methods.The combination group received peripheral vascular endovascular intervention combined with VSD therapy,the intervention group received peripheral endovascular intervention alone,and the VSD group received VSD therapy alone.All patients were given routine fundamental treatments such as anti-infection,blood sugar control,microcirculation improvement,and comorbidity control.The wound bed score(WBS)score and clinical efficacy of the three groups were also compared.Result At 7,14,and 30 days after the operation,the WBS total scores of the three groups were increased,and the WBS total scores of the combined group were higher than those of the other two groups,the differences were statistically significant(P<0.05).There was no significant difference in WBS total score between the intervention group and the VSD group at each time point(P>0.05).On the 30th day after the operation,the WBS score of the three groups were higher than those before operation,further pairwise comparison indicated that the scores of black scab area,granulation growth,exudation amount,edema degree,and pink granulation area in the combined group were all higher than the other two groups,the differences were statistically significant(P<0.05).There was no significant difference in WBS score between the intervention group and the VSD group(P>0.05).At 30 days after the operation,the total effective rate of the three groups was compared

关 键 词：经皮腔内血管成形术 负压封闭引流技术 糖尿病足溃疡 临床疗效 

分 类 号：R543[医药卫生—心血管疾病]