浓缩生长因子在糖尿病足创面修复中的疗效观察  

Observation on the effect of concentrated growth factor in diabetic foot wounds repair

作　　者：王耀金 王丽英[2] 赵杰[2] 周中杰 李永林[2] 薛会朝[1] Wang Yaojin;Wang Liying;Zhao Jie;Zhou Zhongjie;Li Yonglin;Xue Huichao(The First Affiliated Hospital,Xinxiang Medical University,Xinxiang,Henan 453000,China;Department of Orthopeadic,the First People's Hospital of Zhengzhou,Zhengzhou,Henan 450000,China)

机构地区：[1]新乡医学院第一附属医院,河南新乡453000 [2]郑州市第一人民医院整形外科,河南郑州450000

出　　处：《感染．炎症．修复》2023年第1期13-16,F0002,共5页Infection Inflammation Repair

基　　金：河南省医学科技攻关计划联合共建项目:浓缩生长因子在糖尿病足创面修复作用的临床研究(LHGJ20220814)。

摘　　要：目的:探讨浓缩生长因子(CGF)在糖尿病足创面修复中的应用效果。方法:选取新乡医学院第一附属医院收治的Wagner 1~3级糖尿病足患者45例作为CGF组,以同期同科室一般资料相匹配的45例糖尿病足患者作为对照组。对照组清除创面坏死组织及分泌物后用无菌双氧水、庆大霉素生理盐水反复冲洗,碘伏消毒创面后涂抹百多邦(对百多邦过敏者改用多黏菌素),用新型自黏性软聚硅酮泡沫敷料覆盖创面。CGF组在对照组创面处理的基础上外敷自体CGF凝胶。观察两组创面愈合时间、换药次数、创面细菌培养情况、治疗3周时的临床疗效及治疗期间和出院随访4周内的不良反应。结果:CGF组治疗总有效率高于对照组(95.56%比71.11%,χ^(2)=9.680,P<0.05),CGF组换药次数和愈合时间均少于对照组[换药次数:(4.89±1.27)次比(15.98±3.14)次;愈合时间:(19.82±3.72)d比(28.80±4.33)d;P<0.05],治疗前两组患者创面均全部培养出细菌,治疗第7、14、21天时,CGF组的细菌培养阳性率均低于对照组(P<0.05)。CGF组无不良反应发生,对照组2例患者创面分泌物增加伴疼痛加重,给予负压封闭引流及加强换药后缓解。结论:自体CGF能够促进糖尿病足创面愈合,减少换药次数,且抑菌效果好,值得在临床中进一步推广。Objective:To investigate the effect of concentrated growth factor(CGF)in the repair of diabetic foot wounds.Methods:Forty-five patients with Wanger 1 to 3 diabetic foot admitted to the First Affiliated Hospital of Xinxiang Medical Uni⁃versity were selected as the CGF group,and another 45 diabetic foot patients matched with the general data of the same depart⁃ment during the same period were selected as the control group.After removing the wound necrotic tissue and secretions,the control group was repeatedly rinsed with sterile hydrogen peroxide and gentamicin saline,and the wound was disinfected with io⁃dophor and applied with Bactroban(polymyxin was used for those were allergic to Bactroban),and the wound was covered with a new self-adhesive soft polysilicone foam dressing.The CGF group was externally applied with autologous CGF gel on the basis of wound treatment in the control group.The wound healing time,dressing change times,wound bacterial culture,clinical efficacy at 3 weeks of treatment and adverse reactions during treatment and within 4 weeks of discharge were observed in the two groups.Results:The total effective rate of CGF group was higher than that in the control group(95.56%vs 71.11%,χ^(2)=9.680,P<0.05),and the dressing change times and healing time of the CGF group were less than those in the control group[dressing change times:(4.89±1.27)vs.(15.98±3.14);healing time:(19.82±3.72)d vs.(28.80±4.33)d;P<0.05].All the bac⁃teria were cultured on the wounds in the two groups before treatment.On the 7th,14th and 21st days of treatment,the positive rates of bacterial culture in the CGF group were lower than that in the control group(P<0.05).There were no adverse reactions in the CGF group.In the control group,2 patients with increased wound secretions and increased pain were relieved after receiv⁃ing vacuum sealing drainage and intensive dressing change.Conclusions:Autologous CGF can promote the healing of diabetic foot wounds,reduce the dressing change times,and has a good bacteriostatic eff

关 键 词：浓缩生长因子 创面 修复 糖尿病足 换药 

分 类 号：R62[医药卫生—整形外科] R587.2[医药卫生—外科学]