改良胫骨横向骨搬移术治疗糖尿病足溃疡疗效观察  

Curative effect of modified lateral tibial bone transfer in the treatment of diabetes foot ulcer

作　　者：高博 王红武 张彦祥[1] 王艳 付海宁[2] GAO Bo;WANG Hong-wu;ZHANG Yan-xiang;WANG Yan;FU Hai-ning(Second Department of Orthopedics,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA;Department of Laboratory Medicine,Baoji Maternal and Child Health Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]宝鸡市人民医院骨二科,陕西宝鸡721000 [2]宝鸡市妇幼保健院检验科,陕西宝鸡721000

出　　处：《海南医学》2022年第22期2910-2913,共4页Hainan Medical Journal

基　　金：陕西省科学技术研究发展计划项目(编号:2016SF-217)。

摘　　要：目的观察改良胫骨横向骨搬移术治疗糖尿病足溃疡(DFU)的疗效,并探讨其对患者血清C反应蛋白(CRP)、降钙素原(PCT)水平的影响。方法选择2016年8月至2021年5月宝鸡市人民医院骨二科收治的80例DFU患者为研究对象,采用随机数表法分对照组(开放性清创术)和观察组(改良胫骨横向骨搬移术),各40例。比较两组患者的治疗效果,以及治疗前后的踝肱指数(ABI)、密歇根神经体征评分(MNSI)、血清C反应蛋白(CRP)、降钙素原(PCT)水平、创面面积及生活质量量表(GQOL-74)评分的变化。结果观察组患者的治疗总有效率为97.50%,明显高于对照组的82.50%,差异具有统计学意义(P<0.05);治疗后,两组患者的ABI升高,且观察组为0.98±0.10,明显高于对照组的0.79±0.09,而MNSI降低,且观察组为(3.78±0.91)分,明显低于对照组的(4.98±0.89)分,差异均有统计学意义(P<0.05);治疗后,两组患者的CRP、PCT及创面面积均降低,且观察组分别为(4.89±0.97)mg/L、(0.98±0.12)μg/L、(4.41±0.76)cm2,明显低(小)于对照组的(6.13±0.89)mg/L、(1.89±0.42)μg/L、(5.98±0.83)cm2,差异均有统计学意义(P<0.05);治疗后,两组患者的GQOL-74评分中的心理功能、物质生活、躯体功能、社会功能评分均升高,且观察组分别为(68.41±5.23)分、(70.41±5.87)分、(73.41±5.09)分、(69.41±4.91)分,明显高于对照组的(63.41±4.98)分、(64.51±4.97)分、(65.66±4.98)分、(62.45±6.01)分,差异均有统计学意义(P<0.05)。结论改良胫骨横向骨搬移术治疗DFU可促进创面愈合,调节血清炎症因子及促进周围神经恢复,提高患者生活质量,临床应用效果显著。Objective To observe the curative effect of modified lateral tibial bone transfer on diabetes foot ulcer(DFU)and to explore its effect on the levels of serum C-reactive protein(CRP)and procalcitonin(PCT).Methods Eighty patients with DFU admitted to the Second Department of Orthopaedics,Baoji People's Hospital from August 2016 to May 2021 were selected as the study subjects.They were randomly divided into the control group(treated with open debridement)and the observation group(treated with modified lateral tibial bone transfer),each with 40 cases.The curative effects of the two groups were compared,as well as the changes of ankle brachial index(ABI),Michigan neurological sign score(MNSI),serum C-reactive protein(CRP),procalcitonin(PCT),wound area,and Generic Quality of Life Inventory-74(GQOL-74)score before and after treatment.Results The total effective rate of the observation group was 97.50%,which was significantly higher than 82.50%of the control group(P<0.05).After treatment,the ABI of the patients in the two groups increased;the level in the observation group was 0.98±0.10,which was significantly higher than 0.79±0.09 in the control group;the differences were statistically significant(P<0.05).After treatment,the MNSI decreased in the two groups;the score in the observation group was(3.78±0.91)points,which was significantly lower than(4.98±0.89)points in the control group;the differences were statistically significant(P<0.05).After treatment,CRP,PCT,and wound area of the two groups were decreased;the levels of the observation group were(4.89±0.97)mg/L,(0.98±0.12)μg/L,(4.41±0.76)cm2,significantly lower(smaller)than(6.13±0.89)mg/L,(1.89±0.42)μg/L,(5.98±0.83)cm2 of the control group;the differences were statistically significant(P<0.05).After treatment,the scores of psychological function,material life,physical function,and social function in GQOL-74 of the two groups increased,and the scores of the observation group were(68.41±5.23)points,(70.41±5.87)points,(73.41±5.09)points,and(69.41±4.91)poi

关 键 词：糖尿病足溃疡 改良胫骨横向骨搬移术 C反应蛋白 降钙素原 密歇根神经体征评分 生活质量 疗效 

分 类 号：R587.2[医药卫生—内分泌]