负压创伤治疗技术及生物半透膜覆盖治疗糖尿病皮肤慢性溃疡

背景：糖尿病患者全身营养状况不良和免疫功能低下导致其皮肤慢性溃疡愈合困难，常规创面治疗方法效果不佳。目的：探讨负压创伤治疗技术在糖尿病皮肤慢性溃疡治疗中的安全性和有效性。方法：纳入2007年7月至2010年12月在广西壮族自治区人民医院内分泌科治疗的糖尿病皮肤慢性溃疡患者144例，其中糖尿病足溃疡132例，压疮12例。分别采用负压创伤治疗技术或传统清创、换药方法治疗；同时均辅以控制血糖及血压、抗凝、抗感染及对症1支持治疗。结果与结论：采刚负压创伤治疗技术治疗的109例患者溃疡愈合60例，显效30例，有效14例，无效5例，总何效率95．4％。采用传统清创、换药方法治疗的35例患者溃疡愈合17例，显效10例，有效3例，无效5例，总有效率85.7％。两组总有效率比较差异有显著性意义（P〈0．05）。且负压创伤治疗可明显提高糖尿病足溃疡患者溃疡州边组纵氧分压，负压泵连续运行最长120d，无并发症出现。说明负压创伤治疗技术在糖尿病皮肤慢性溃疡治疗中具有良好的安全性和有效性。

Negative pressure wound therapy and biological semipermeable membrane covering for the treatment of diabetic skin chronic ulcers

BACKGROUND： Because of the malnourished condition and low immunity, the chronic diabetic skin ulcer is difficult to heal and the conventional wound treatment is ineffective. OBJECTIVE： To evaluate the efficacy and safety of negative pressure wound therapy on the treatment of diabetic skin chronic ulcers. METHODS： 144 patients with diabetic skin chronic ulcers （132 with diabetic foot ulcers and 12 with pressure sore） were collected from the Department of Endocrinology, the People＇s Hospital of Guangxi Zhuang Autonomous Region during July 2007 to December 2010. The patients were treated with negative pressure wound therapy and routine treatment method respectively, and supplemented with blood sugar controlling and blood pressure controlling, anticoagulation, anti-infective and other symptomatic and supportive treatment. RESULTS AND CONCLUSION： Among the 109 patients that treated with negative pressure wound therapy, 60 patients were healed, 30 patients significant effective, 14 patients were effective, and 5 patients were ineffective with total effective rate of 95.4% Among the 35 patients that treated with routine treatment method, 17 patients were healed, 10 patients were significant effective, three patients were effective, and five patients were ineffective with total effective rate of 85.7% There was a significant difference in the total effective rate between two groups （P 〈 0.05）. Negative pressure wound therapy could significantly improve the tissue oxygen partial pressure around the ulcers of the patients with diabetic foot ulcers, and the maximum continuous operation time of the negative pressure pump was 120 days without complications. It indicates that negative pressure wound therapy is safe and effective for the treatment of chronic diabetic skin ulcer.