应用羧甲基纤维素钠银敷料联合封闭负压吸引治疗糖尿病足溃疡的疗效  

Analysis on the clinical efficacy of sodium carboxyl-methyl-cellulose dressings combined with vacuum sealing drainage in the treatment of diabetic foot ulcer

作　　者：鲍亚慧 曹志斌 王健楠 别瑶 孙晓东[1] 惠宗光[1] Bao Yahui;Cao Zhibin;Wang Jiannan;Bie Yao;Sun Xiaodong;Hui Zongguang(Department of Endocrinology and Metabolism,Affiliated Hospital of Weifang Medical University,Weifang 261031,China)

机构地区：[1]潍坊医学院附属医院内分泌代谢病科,261031

出　　处：《中华损伤与修复杂志（电子版）》2023年第4期326-330,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：国家自然科学基金资助项目(81870593)。

摘　　要：目的探讨羧甲基纤维素钠银敷料(CMC-Na)联合封闭负压吸引(VSD)技术治疗糖尿病足溃疡的疗效。方法选择2020年10月1日至2021年12月31日潍坊医学院附属医院内分泌代谢病科收治的糖尿病足患者120例,根据治疗方案不同分为对照组、CMC-Na组、CMC-Na联合VSD组,每组40例。在常规降糖和抗感染治疗基础上,对照组给予黄柏液冲洗及生理盐水纱布敷贴治疗,CMC-Na组在对照组基础上给予CMC-Na治疗,CMC-Na联合VSD组在对照组基础上给予CMC-Na联合VSD治疗。比较3组患者治疗1、2、4周后糖尿病足溃疡创面缩小率、窦道深度变化情况、疗效及患者满意度。结果(1)创面缩小率:3组创面缩小率均随治疗时间的延长呈增加趋势(F=203.588、582.072、606.211,P<0.05);治疗1、2周,CMC-Na联合VSD组均优于对照组,差异有统计学意义(t=6.920、23.086,P<0.05),与CMC-Na组比较差异均无统计学意义(t=3.064、14.305,P>0.05);治疗4周,CMC-Na联合VSD组显著优于对照组和CMC-Na组,差异有统计学意义(t=-7.038、-4.999,P<0.05)。(2)窦道深度变化情况:3组窦道深度均随治疗时间的延长呈递减趋势(F=7.888、4.197、12.388,P<0.05);CMC-Na联合VSD组显著优于对照组,差异有统计学意义(t=-2.293、-2.958、-3.289,P<0.05);与CMC-Na组比较,CMC-Na联合VSD组窦道深度更小,但差异无统计学意义(t=-0.241、-1.166,-1.162,P>0.05)。(3)总有效率:3组总有效率分别为75.0%、92.5%、97.5%,差异有统计学意义(χ^(2)=10.836,P<0.05)。(4)患者满意度:3组患者满意度分别为45.0%、82.5%、95.0%,差异有统计学意义(χ^(2)=8.683,P<0.05)。结论羧甲基纤维素钠银敷料联合封闭负压吸引治疗糖尿病足溃疡可显著促进创面愈合,提高患者满意度。Objective To discuss the clinical efficacy of sodium carboxyl-methyl-cellulose dressings(CMC-Na)combined with vacuum sealing drainage(VSD)in the treatment of diabetic foot ulcer.Methods A total of 120 patients with diabetic foot admitted to Department of Endocrinology and Metabolism,Affiliated Hospital of Weifang Medical University from October 1,2020 to December 31,2021 were selected.The patients were divided into control group,CMC-Na group,and CMC-Na combined with VSD group according to different treatment plans,with 40 cases in each group.On the basis of conventional hypoglycemia and anti-infection,the control group was treated with Huangbai liquid rinsing and saline gauze dressing,the CMC-Na group was treated with CMC-Na on the basis of the control group,and the CMC-Na combined with VSD group was treated with CMC-Na combined with VSD on the basis of the control group.At 1 week,2 weeks and 4 weeks of treatment,the reduction rate of diabetes foot ulcer wound,changes in sinus depth,curative effect and patient satisfaction were compared among the three groups.Results(1)Ulcer wound reduction rate:all three groups showed an increasing trend of ulcer wound reduction rate with the extension of the treatment time(F=203.588,582.072,606.211;P<0.05).At 1 week and 2 weeks of treatment,the CMC-Na combined with VSD group was superior to the control group,and the difference was statistically significant(t=6.920,23.086;P<0.05),but there was no difference between the CMC-Na combined with VSD group and the CMC-Na group(t=3.064,14.305;P>0.05).At 4 weeks of treatment,the CMC-Na combined with VSD group was significantly better than the control group and the CMC-Na group,and the difference was statistically significant(t=-7.038,-4.999;P<0.05).(2)Changes in sinus depth:all three groups showed a decreasing trend in sinus depth with the extension of treatment time(F=7.888,4.197,12.388;P<0.05).The CMC-Na combined with VSD group was significantly better than the control group,and the difference was statistically significant(t=-2.293,-2.

关 键 词：糖尿病足溃疡 羧甲基纤维素钠 封闭负压吸引 

分 类 号：R587.2[医药卫生—内分泌]