胫骨横向搬移术联合负压引流技术治疗糖尿病足的效果  

Clinical efficacy of tibial transverse transport combined with vacuum sealing drainage for diabetic foot

作　　者：张雅琼 马红伟 刘攀云 郭卫波 ZHANG Yaqiong;MA Hongwei;LIU Panyun(Department of Endocrinology,81st Group Army Hospital,PLA,Hebei,Zhangjiakou 075000,China)

机构地区：[1]中国人民解放军陆军第八十一集团军医院内分泌科,河北省张家口市075000 [2]张家口华奥医院消化内科

出　　处：《河北医药》2023年第7期1054-1056,1060,共4页Hebei Medical Journal

基　　金：张家口市科学技术研究与发展计划项目(编号:1821117D)。

摘　　要：目的研究糖尿病足患者采用胫骨横向搬移术联合负压引流(VSD)技术治疗的临床价值。方法选取2019年10月至2021年10月糖尿病足患者64例,按治疗方法不同分为2组,对照组30例予以VSD技术治疗,观察组34例基于对照组条件施加胫骨横向搬移术治疗,比较2组处理情况。结果观察组治疗12周后总有效率高于对照组,差异有统计学意义(P<0.05)。2组治疗前足部疼痛评分比较,差异无统计学意义(P>0.05);治疗12周后,观察组足部疼痛评分比对照组更低,差异有统计学意义(P<0.05)。观察组治疗后麻木、疼痛、冷感、间歇性跛行改善优于对照组(P<0.05)。观察组治疗后ABI(1.04±0.25)、TcPO2(42.82±8.12)mm Hg高于对照组,差异有统计学意义(P<0.05)。观察组患者创面肉芽组织中VEGF(8077.65±147.42)IOD、SDF-1α(5224.09±125.45)IOD、CXCR4(14279.86±289.94)IOD水平显著高于对照组,2组比较差异有统计学意义(P<0.05)。结论胫骨横向搬移术联合VSD技术用于糖尿病足患者的治疗效果显著,并可加快疼痛缓解,促进创面恢复,值得临床推荐。Objective To study the clinical efficacy of tibial transverse transport(TTT)combined with vacuum sealing drainage(VSD)for diabetic foot(DF).Methods From October 2019 to October 2021,totally 64 DF patients were assigned into the observation group(n=34)and the control group(n=30)based on the treatment methods.All patients were managed by VSD,and those in the observation group were additionally treated with TTT.The therapeutic effects in the both groups were compared.Results The overall effective rate on week 12 in the observation group was significantly higher than that in the control group(P<0.05).The difference was not statistically significant in the visual analog scale(VAS)for pain between groups before treatment(P>0.05).The VAS for pain on week 12 in the observation group was notably lower compared with the control group(P<0.05).After treatment,the improvement of numbness,pain,cold sensation,intermittent claudication in the observation group was superior to the control group(P<0.05).The ankle-brachial index(ABI)and transcutaneous oxygen pressure(TcPO2)in the observation group were(1.04±0.25),(42.82±8.12)mmHg,respectively,which were significantly higher than the control group(P<0.05).The integrated optical density(IOD)of vascular endothelial growth factor(VEGF),C-X-C chemokine receptor type 4(CXCR4),stromal cell-derived factor 1 alpha(SDF-1α)in granulation tissue of wound in the observation group were(8,077.65±147.42),(5,224.09±125.45),(14,279.86±289.94),respectively,which were significantly higher than the control group(P<0.05).Conclusion For DF patients,TTT combined with VSD has a significant therapeutic effect,which can quickly relieve pain and promote wound recovery,and it is worthy of clinical reference.

关 键 词：糖尿病足 胫骨横向搬移术 负压引流技术 临床疗效 创面恢复 

分 类 号：R587.2[医药卫生—内分泌]