负压滴灌治疗联合红蓝光对糖尿病足创面的疗效研究  

Effect of Negative-pressure Wound Therapy with Irrigation Combined with Red and Blue Light on Diabetic Foot Wounds

作　　者：孙好杰 耿厚法 窦连军[1] 梁军[1] SUN Haojie;GENG Houfa;DOU Lianjun(Department of Endocrinology,Xuzhou Central Hospital,Xuzhou Clinical School of Xuzhou Medical University,Jiangsu 221009,China)

机构地区：[1]徐州市中心医院内分泌科、徐州医科大学徐州临床学院,221009

出　　处：《医学研究杂志》2023年第11期118-122,共5页Journal of Medical Research

基　　金：江苏省医学重点人才项目(ZDRCC2016022);江苏省徐州市科技计划项目(KC21274);徐州医科大学附属医院发展基金资助项目(XYFM2020010)。

摘　　要：目的评价负压滴灌治疗(negative-pressure wound therapy with irrigation,NPWTi)联合红蓝光对糖尿病足创面的疗效。方法选取2021年12月~2022年5月徐州市中心医院收治的80例2型糖尿病合并糖尿病足患者,采用随机数字表法将其分为对照组和NPWTi+红蓝光组,每组各40例。所有患者均接受基础治疗,对照组采用NPWTi治疗,NPWTi+红蓝光组在NPWTi的基础上给予红蓝光治疗。观察治疗前和治疗7天后创面愈合速率、血清炎性指标[红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)及降钙素原(procalcitonin,PCT)]和生长因子[血管内皮生长因子(vascular endothelial growth factor,VEGF)、表皮生长因子(epidermal growth factor,EGF)和碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)]的变化。随访12周,观察两组的创面愈合率,并通过Kaplan-Meier曲线评估两组累积创面愈合率。结果治疗7天后,NPWTi+红蓝光组创面愈合速率快于对照组(P<0.01),VEGF、EGF及bFGF水平高于对照组(P<0.05),ESR、CRP及PCT水平均低于对照组(P<0.05)。NPWTi+红蓝光组12周创面愈合率高于对照组(P<0.05)。Kaplan-Meier曲线分析结果显示,NPWTi+红蓝光组的累积创面愈合率高于对照组(P<0.05)。结论负压滴灌治疗联合红蓝光对糖尿病足创面是有效的,值得在临床上推广应用。Objective To evaluate the effect of negative-pressure wound therapy with irrigation(NPWTi)combined with red and blue light on diabetic foot wounds.Methods According to random number method,a total of 80 patients with type 2diabetes combined with diabetic foot admitted to Xuzhou Central Hospital from December 2021 to May 2022 were selected and divided into two groups:control group and NPWTi+red and blue light group,with 40 cases in each group.All patients received basic treatment,while the control group received NPWTi treatment,NPWTi+red and blue light group was treated with red and blue light on the basis of NPWTi.The changes of wound healing speed rate,serum inflammatory markers[erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),procalcitonin(PCT)]and growth factors[vascular endothelial growth factor(VEGF),epidermal growth factor(EGF),basic fibroblast growth factor(bFGF)]were observed before and 7days after treatment.After 12 weeks of follow-up,the wound healing rate of the two groups were observed,and the cumulative wound healing rate of the two groups was evaluated through Kaplan-Meier curve.Results After 7days of treatment,the wound healing rate of NPWTi+red and blue light group was faster than that of the control group(P<0.01).The average levels of VEGF,EGF and bFGF in NPWTi+red blue light group were higher than those in the control group(P<0.05),while the average levels of ESR,CRP and,PCT in NPWTi+red and blue light group were lower than those in the control group(P<0.05).The wound healing rate of NPWTi+red and blue light group at 12 weeks was higher than that of the control group(P<0.05).Kaplan-Meier curve analysis showed that the cumulative wound healing rate of NPWTi+red and blue light group was higher than that of the control group(P<0.05).Conclusion NPWTi combined with red and blue light is effective in treating diabetic foot wounds,and it is worthy of clinical application.

关 键 词：糖尿病足 负压滴灌治疗 红蓝光 创面 

分 类 号：R587[医药卫生—内分泌]