富血小板血浆联合负压封闭引流技术对糖尿病足的治疗效果及创面愈合不良的危险因素  

Therapeutic effect of platelet-rich plasma combined with vacuum sealing drainage on diabetic foot patients and the risk factors of poor wound healing

作　　者：董娟[1] 薛小萍[1] DONG Juan;XUE Xiaoping(Department of Blood Transfusion,Subei People's Hospital of Jiangsu province,Yangzhou,Jiangsu 225001,China)

机构地区：[1]江苏省苏北人民医院输血科,江苏扬州225001

出　　处：《徐州医科大学学报》2024年第3期181-186,共6页Journal of Xuzhou Medical University

基　　金：江苏省卫生健康委科研项目(Z202201050)。

摘　　要：目的 探讨富血小板血浆(PRP)联合负压封闭引流技术(VSD)对糖尿病足(DF)患者的治疗效果并分析造成创面愈合不良的危险因素。方法 选择2022年6月-2023年6月江苏省苏北人民医院收治的110例DF患者,根据治疗方式分为2组,每组55例,对照组采取常规治疗联合VSD治疗,观察组在对照组基础上联合PRP治疗。比较2组治疗4周后临床疗效及治疗前、治疗4周时病灶症状评分、足背动脉指标(血流量、管腔内径、搏动指数)。根据患者治疗4周时创面愈合情况,分为创面愈合良好组和创面愈合不良组,采用二元logistic回归分析各因素与DF患者创面愈合不良的关系。结果 治疗4周后,观察组总有效率高于对照组(P<0.05);2组病灶症状评分低于治疗前,观察组低于对照组(P<0.05);2组血流量、管腔内径、搏动指数高于治疗前,观察组高于对照组(P<0.05)。创面愈合不良组溃疡面积、入院时空腹血糖(FBG)水平高于创面愈合良好组,Wangner分级为Ⅲ级、营养不良、吸烟患者占比高于创面愈合良好组(P<0.05);溃疡面积大、入院时FBG水平高及营养不良、吸烟是DF患者创面愈合不良的危险因素(P<0.05)。结论 PRP联合VSD能够有效改善DF患者临床症状,促进创面愈合,改善足部血流;溃疡面积、入院时FBG水平、营养状况及吸烟与DF患者创面愈合不良有关。Objective To investigate the therapeutic effect of platelet-rich plasma(PRP)combined with vacuum sealing drainage(VSD)on patients with diabetic foot(DF)and to analyze the risk factors of poor wound healing.Methods A total of 110 DF patients who were admitted to Subei People's Hospital of Jiangsu province from June 2022 to June 2023 were selected.According to the treatment methods,they were divided into two groups(n=55):a control group receiving conventional therapy combined with VSD and an observation group receiving PRP in addition to the therapies in the control group.After four-week treatment,both groups were compared for the clinical efficacy,the lesion symptom score,and adorsalis pedis artery index(blood flow,lumen diameter,and pulsatility index).According to the wound healing after four-week treatment,the patients were divided into a good wound healing group,and a poor wound healing group.The relationship between various factors and poor wound healing in DF patients was analyzed by bivariate logistic regression.Results After four-week treatment,the observation group showed a higher total effective rate than the control group(P<0.05).Compared with those before treatment,both groups showed reduced lesion symptom scores after treatment,where higher scores were found in the observation group than the control group(P<0.05).Meanwhile,the blood flow,lumen diameter and pulsatility index decreased in the two groups,compared with those before treatment,and higher values were found in the observation group(P<0.05).The poor wound healing group presented increases in the ulcer area and fasting blood glucose(FBG)level at admission,as well as decreases in the proportions of patients with Wangner grade III,malnutrition and smoking,compared with the good wound healing group(P<0.05).Large ulcer area,high FBG level at admission,malnutrition and smoking were risk factors for poor wound healing in DF patients(P<0.05).Conclusions PRP combined with VSD can effectively improve the clinical symptoms of DF patients,promote wound hea

关 键 词：糖尿病足 富血小板血浆 负压封闭引流技术 创面愈合 危险因素 

分 类 号：R587.1[医药卫生—内分泌]