自体富血小板凝胶联合负压封闭引流在糖尿病足溃疡中的应用  

Application of autologous platelet-rich gel combined with vacuum sealing drainage in the treatment of diabetic foot ulcers

作　　者：张静 任丽君 刘银龙 Zhang Jing;Ren Lijun;Liu Yinlong(Department of Plastic and Reconstructive Surgery,Henan Provincial Third People’s Hospital,Zhengzhou 450018,China)

机构地区：[1]河南省直第三人民医院整形修复科,郑州450018

出　　处：《中国实用医刊》2024年第21期42-45,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析自体富血小板凝胶(APG)联合负压封闭引流(VSD)在糖尿病足溃疡中的应用价值。方法队列研究。抽取2022年8月至2024年2月在河南省直第三人民医院收集的病例进行研究,将76例符合纳排标准的糖尿病足溃疡患者按随机数字表法分为APG联合VSD组与VSD组,每组38例。VSD组采用VSD,APG联合VSD组采用APG联合VSD。比较两组疗效,创面愈合情况,疼痛评分、瘙痒评分,生长因子[血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)、转化生长因子-β1(TGF-β1)]水平、炎症因子[白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)]水平及不良反应发生率。结果APG联合VSD组总有效率(94.74%,36/38)高于VSD组(78.95%,30/38),P<0.05。APG联合VSD组肉芽组织覆盖率高于VSD组,肉芽组织生长厚度大于VSD组,创面愈合时间短于VSD组(P<0.05)。APG联合VSD组疼痛、瘙痒评分低于VSD组(P<0.05)。APG联合VSD组VEGF、bFGF、TGF-β1水平高于VSD组(P<0.05)。APG联合VSD组IL-1、TNF-α水平低于VSD组(P<0.05)。APG联合VSD组不良反应发生率(5.26%,2/38)低于VSD组(21.05%,8/38),P<0.05。结论APG联合VSD治疗糖尿病足溃疡效果显著,可调节生长因子表达,减轻炎性反应,加快创面愈合。ObjectiveTo analyze the value of autologous platelet-rich gel(APG)combined with vacuum sealing drainage(VSD)in the treatment of diabetic foot ulcers.MethodsCases were collected from Henan Provincial Third People’s Hospital from August 2022 to February 2024 for the cohort study.Seventy-six patients with diabetic foot ulcers met the criteria for natriuresis,and they were divided into APG combined with VSD group and VSD group by random number table method,with 38 cases in each group.The VSD group was treated by VSD,and the APG combined with VSD group was treated by APG combined with VSD.The treatment efficacy,wound healing,pain score,itch score,levels of growth factors including vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)and transforming growth factor-β1(TGF-β1),levels of inflammatory factors,including interleukin-1(IL-1)and tumor necrosis factor-α(TNF-α),and incidence of adverse effects were compared between the two groups.ResultsThe total effective rate of the APG combined with VSD group(94.74%,36/38)was higher than that of the VSD group(78.95%,30/38),P<0.05.Compared with the VSD group,the APG combined with VSD group had higher granulation tissue coverage,thicker granulation tissue growth thickness,and shorter wound healing time(P<0.05).The scores of pain and itching in the APG combined with VSD group were lower than those in the VSD group(P<0.05).The levels of VEGF,bFGF and TGF-β1 in the APG combined with VSD group were higher than those in the VSD group(P<0.05).The levels of IL-1 and TNF-αin the APG combined with VSD group were lower than those in the VSD group(P<0.05).The incidence of adverse reactions in the APG combined with VSD group(5.26%,2/38)was lower than that in the VSD group(21.05%,8/38),P<0.05.ConclusionsAPG combined with VSD is effective in the treatment of diabetic foot ulcers,which can regulate the expression of growth factors,reduce the inflammatory response,and accelerate wound healing.

关 键 词：糖尿病足 负压封闭引流 自体富血小板凝胶 

分 类 号：R587.2[医药卫生—内分泌]