胫骨中段及近端皮质横向搬移治疗糖尿病足溃疡的疗效和安全性研究  

Study on the Efficacy and Safety of Middle Tibial Cortex Transverse Transport and Proximal Tibial Cortex Transverse Transport in the Treatment of Diabetic Foot Ulcer

作　　者：桂瑞明 GUI Ruiming(Department of General Surgery,Yujiang District Second People's Hospital of Yingtan City,Yingtan 335203,Jiangxi,China)

机构地区：[1]鹰潭市余江区第二人民医院普外科,江西鹰潭335203

出　　处：《医学信息》2024年第20期76-79,共4页Journal of Medical Information

摘　　要：目的研究胫骨中段及近端皮质横向搬移治疗糖尿病足溃疡(DFU)的疗效和安全性。方法以2021年1月-2023年4月鹰潭市余江区第二人民医院收治的63例DFU患者为研究对象,经随机数字表法分为中段组(31例)与近端组(32例)。中段组采用胫骨中段皮质横向搬移治疗,近端组应用胫骨近端皮质横向搬移治疗,比较两组手术疗效、手术相关指标(手术时间、术中出血量、术后住院时间、溃疡愈合时间)、临床症状[足部皮温、疼痛视觉模拟评分(VAS)、踝肱指数(ABI)]、术后并发症。结果两组手术疗效比较,差异无统计学意义(P>0.05)。近端组手术时间、术后住院时间短于中段组,术中出血量少于中段组(P<0.05)。术后3个月,两组患者的足部皮温、ABI高于术前,VAS评分低于术前(P<0.05),组间比较,差异无统计学意义(P>0.05)。近端组术后并发症发生率低于中段组(P<0.05)。结论胫骨中段及近端皮质横向搬移治疗DFU效果确切,二者疗效相当,可改善患者症状表现,但胫骨近端皮质横向搬移治疗的手术时间及术中出血更少,可缩短患者术后住院时间,降低其术后并发症发生风险。Objective To study the efficacy and safety of middle tibial cortex transverse transport and proximal tibial cortex transverse transport in the treatment of diabetes foot ulcer(DFU).Methods A total of 63 patients with DFU admitted to Yujiang District Second People's Hospital of Yingtan City from January 2021 to April 2023 were enrolled in the study.They were divided into the middle group(31 patients)and the proximal group(32 patients)by random number table method.The middle group was treated with middle tibial cortex transverse transport,and the proximal group was treated with proximal tibial cortex transverse transport.The surgical efficacy,surgical related indicators(operation time,intraoperative blood loss,postoperative hospital stay,ulcer healing time),clinical symptoms[foot skin temperature,pain Visual Analogue Scale(VAS),ankle brachial index(ABI)],postoperative complications were compared between the two groups.Results There was no significant difference in surgical efficacy between the two groups(P>0.05).The operation time and postoperative hospital stay in the proximal group were shorter than those in the middle group,and the intraoperative blood loss was less than that in the middle group(P<0.05).At 3 months after operation,the foot skin temperature and ABI of the two groups were higher than those before operation,and the VAS score was lower than that before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The incidence of postoperative complications in the proximal group was lower than that in the middle group(P<0.05).Conclusion The middle tibial cortex transverse transport and proximal tibial cortex transverse transport is effective in the treatment of DFU.The two methods have similar efficacy and can improve the symptoms of patients.However,the operation time and intraoperative bleeding of the proximal tibial cortex transverse transport are less,which can shorten the postoperative hospital stay and reduce the risk of postoperative complications.

关 键 词：糖尿病足溃疡 胫骨近端 胫骨中段 皮质横向搬移治疗 手术时间 手术并发症 

分 类 号：R587.2[医药卫生—内分泌]