封闭式负压引流联合三种不同方法治疗糖尿病足溃疡的疗效分析  

Clinical analysis of 126 cases of diabetes foot ulcer treated by closed negative pressure drainage combined with three difffferent methods

作　　者：曾婷 吕晋元 谭映雪 黄新宇 卫向红[1] ZENG Ting;LÜJin-yuan;TAN Ying-xue;HUANG Xin-yu;WEI Xiang-hong(School of Medicine,Wuhan University of Science and Technology,Hubei Province,430081 China;Department of dermatology,Luohe Second People's Hospital,Henan Province,462099,China;Department of burn and sore plastic surgery,The First Hospital of Hunan University of Chinese Medicine,Hunan Province,410021,China)

机构地区：[1]武汉科技大学医学院,湖北武汉430081 [2]漯河市第二人民医院皮肤科,河南漯河462099 [3]湖南中医药大学第一附属医院烧伤疮疡整形科,湖南长沙410021

出　　处：《中国医疗美容》2024年第2期50-53,共4页China Medical Cosmetology

摘　　要：目的对比封闭式负压引流(VSD,vacuum sealing drainage)联合重组人酸性成纤维细胞生长因子(rh-aFGF,recombinant human acidic fibroblast growth factor)、封闭式负压引流联合重组人表皮生长因子(rhEGF,recombinant human epidermal growth factor)、封闭式负压引流联合抗生素骨水泥治疗糖尿病足溃疡(diabetic foot ulceration,DFU)的临床效果。方法回顾性分析2021年1月-2023年5月湖南中医附一医院收治的DFU患者126例,根据治疗情况分为VSD联合rh-aFGF组、VSD联合rhEGF组、VSD联合抗生素骨水泥组,每组各42例。比较三组愈合效果以及创面愈合率和创面完全愈合时间。随访6个月,比较三组患者瘢痕面积。结果三组愈合效果、愈合率无统计学意义(P>0.05);VSD联合rhEGF组和VSD联合rh-aFGF组创面完全愈合时间均短于VSD联合抗生素骨水泥组(P<0.05),但VSD联合rhEGF组和VSD联合rh-aFGF组创面完全愈合时间差异无统计学意义(P>0.05)。6个月随访结果显示,VSD联合rhEGF组和VSD联合rh-aFGF组瘢痕面积均小于VSD联合抗生素骨水泥组(P<0.05),但VSD联合rhEGF组和VSD联合rh-aFGF组瘢痕面积差异无统计学意义(P>0.05)。结论VSD联合rh-aFGF、rhEGF、抗生素骨水泥均是治疗DFU的有效方法,VSD联合rh-aFGF和rhEGF对促进创面愈合和缩小瘢痕面积效果相当,且均优于VSD联合抗生素骨水泥。Objective To compare the clinical effffects of VSD(vacuum sealing drainage)combined with recombinant human acidic fibroblast growth factor(rh-aFGF),closed negative pressure drainage combined with recombinant human epidermal growth factor(rhEGF),and closed negative pressure drainage combined with antibiotic bone cement in the treatment of diabetes foot ulcers.Methods According to the treatment situation,126 patients with diabetes foot ulcers were divided into three groups,each with 42 cases,namely VSD combined with rh-aFGF group,VSD combined with rhEGF group,and VSD combined with antibiotic bone cement group.The healing effffects,wound healing rate,complete wound healing time and scar area after 6 months of follow-up among three groups were compared.Results The healing effffect and healing rate of the three groups were not signifificant(P>0.05).The complete wound healing time of the VSD combined with rhEGF group and the VSD combined with rh-aFGF group were shorter than those of VSD combined with antibiotic bone cement group(P<0.05),but there was no difference between the VSD combined with rhEGF group and VSD combined with rh-aFGF group(P>0.05).The 6-month follow-up results showed that the scar area of the VSD combined with rhEGF group and the VSD combined with rh-aFGF group were both smaller than those of the VSD combined with antibiotic bone cement group(P<0.05),but there was no difffference between the VSD combined with rhEGF group and the VSD combined with rh-aFGF group(P>0.05).Conclusions The combination of VSD and rh-aFGF,rhEGF,and antibiotic bone cement were effffective methods for treating DFU.VSD combined with rh-aFGF and rhEGF has similar effffects in promoting wound healing and reducing scar area,and is superior to VSD combined with antibiotic bone cement.

关 键 词：负压引流 糖尿病足溃疡 重组人酸性成纤维细胞生长因子 重组人表皮生长因子 抗生素骨水泥 

分 类 号：R658.3[医药卫生—外科学] R587.2[医药卫生—临床医学]