异种(猪)脱细胞真皮基质在糖尿病足溃疡修复中的应用效果

目的探讨异种(猪)脱细胞真皮基质(ADM)在糖尿病足溃疡修复中的应用效果。 方法选取宁夏回族自治区石嘴山市第一人民医院烧伤整形外科2015年3月至2017年6月收治的76例糖尿病足溃疡患者，采用电脑随机分组法将患者随机分为两组，每组38例，实验组患者应用异种(猪)ADM覆盖治疗，对照组应用磺胺嘧啶银乳膏包扎治疗，观察创面的愈合疗效、愈合时间、换药次数、换药2 h后疼痛视觉模拟评分、愈后患者满意度评分和创面病原菌检出率。对数据行χ²检验、t检验。 结果治疗2周后实验组治疗总有效率(94.74%)高于对照组(78.95%)，差异有统计学意义(χ²＝4.145，P<0.05)；实验组创面愈合时间(24.21±3.21)d]短于对照组(31.89±4.64)d]，实验组创面换药次数(8.34±1.12)次]少于对照组(15.11±1.69)次]，实验组疼痛视觉模拟评分(3.29±0.25)分]低于对照组(4.79±0.74)分]，实验组愈后患者满意度评分(9.08±0.49)分]高于对照组(8.16±0.72)分]，差异均有统计学意义(t＝8.359、20.560、10.364、6.548，P值均小于0.05)；治疗1周后，两组创面分泌物病原菌检出率比较差异无统计学意义(χ²＝2.657，P>0.05)。 结论异种(猪)ADM作为糖尿病足创面覆盖物，改善局部微环境，促进创面肉芽组织生长，缩短创面愈合时间，减少细菌侵入，减轻患者心理和经济负担。

Application effect of xenogeneic(porcine) acellular dermal matrix in the repair of diabetic foot ulcer

ObjectiveTo investigate the effects of xenogeneic(porcine) acellular dermal matrix in the repair of diabetic foot ulcer. MethodsTotally 76 patients with diabetic foot ulcer were randomly divided into two groups according to computer randomization. The 38 patients in the experimental group were treated with porcine acellular dermal matrix, while another 38 patients enrolled in the control group were treated with silver sulfadiazine cream. The curative effect of the wound healing, the healing time, dressing times, pain visual analogue score after dressing, patient satisfaction score and the detection of wound bacteria were observed. The data was subjected to χ² test and t test. ResultsTwo weeks later, the total effective rate of the experimental group treated with the porcine acellular dermal matrix (94.74%) was significantly higher than the control group(78.95%), the difference was statistically significant (χ²=4.145, P<0.05). The healing time of the experimental group(24.21±3.21)d] was significantly shorter than the control group(31.89±4.64)d], dressing times in the experimental group (8.34±1.12)times] was significantly lower than the control group (15.11±1.69) times], pain visual analogue score after dressing in the experimental group (3.29±0.25)points] was significantly lower than the control group (4.79±0.74)points], patient satisfaction score in the experimental group (9.08±0.49) points] was significantly higher than the control group(8.16±0.72) points], the differences were statistically significant(t=8.359, 20.560, 10.364, 6.548, with P values below 0.05). After one week of treatment, there was no significant difference in the detection rate of pathogenic bacteria between the two groups(χ²=2.657, P>0.05). ConclusionsAs a wound covering, porcine acellular dermal matrix can effectively improve local microenvironment, promote granulation tissue growth, shorten wound healing time and reduce the psychological and economic burden on patients.