负压封闭引流联合医用三氧水冲洗治疗糖尿病足的临床效果

目的 观察负压封闭引流技术(VSD)联合医用三氧水冲洗治疗糖尿病足创面的临床效果.方法 将糖尿病足患者83例随机分为对照组45例与观察组38例,对照组给予VSD+生理盐水冲洗,观察组给予VSD+医用三氧水冲洗,比较两组患者治疗前后创面情况及患肢的踝肱指数(ABI),引流管堵塞率、治疗后肉芽组织覆盖率及创面局部组织液氧分压,Ⅱ期创面修复术后的成活率.结果 治疗1个周期后,两组患者创面均出现新生肉芽组织,但观察组较对照组坏死组织及脓胎少,肉芽组织红润、生长好.两组引流管堵塞率比较差异无统计学意义(P>0.05),但观察组的肉芽覆盖率、创面局部组织液氧分压及Ⅱ期创面修复的成活率均优于对照组(P<0.05).治疗前,两组ABI比较差异无统计学意义(P>0.05),治疗1个周期,两组ABI较治疗前均增加,且观察组高于对照组(P<0.05).结论 VSD联合医用三氧水冲洗可清除糖尿病足创面坏死组织,促进创面肉芽组织的生长,有效减少VSD引流管堵塞率,改善组织微循环,纠正创面供血和供氧不足的状态,提高Ⅱ期创面修复的成活率.

Clinical efficacy of vacuum sealing drainage combined with medical ozonated water irrigation for treatment of diabetic foot

Objective To observe the clinical efficacy of vacuum sealing drainage(VSD) combined with medical ozonated water irrigation for the treatment of diabetic foot ulcers.Methods A total of 83 patients with diabetic foot were randomly divided into control group(n=45) and observation group(n=38).The control group was treated with VSD combined with irrigation of normal saline,while the observation group was treated with VSD combined with irrigation of medical ozonated water.The condition of foot ulcers and ipsilateral ankle brachial index(ABI) before and after treatment were compared between the two groups,and the blockage rate of drainage tube,coverage rate of granulation tissues,partial pressure of liquid oxygen in the local wound tissues after treatment,and the postoperative survival rate of stage Ⅱ wound repair were compared as well.Results After one cycle of treatment,the newly formed granulation tissues in wounds were observed in both groups,but less necrotic tissues and pus as well as rosy and well-grew granulation tissues were seen in the observation group compared to the control group.There was no significant difference in the blockage rate of drainage tube between the two groups(P>0.05),but the granulation coverage rate,partial pressure of liquid oxygen in the local wound tissues,and survival rate of stage Ⅱ wound repair in the observation group were better than those in the control group (P<0.05).Before treatment,there was no significant difference in the ABI between the two groups(P>0.05).After one cycle of treatment,ABI increased in both groups compared to the pre-treatment,and ABI in the observation group was higher than that in the control group(P<0.05).Conclusion VSD combined with medical ozonated water irrigation can remove the necrotic wound tissues,promote the granulation tissue growth in wounds,reduce the blockage rate of VSD drainage tube effectively,improve tissue microcirculation,correct the insufficient blood supply and hypoxidosis in wounds,and improve the survival rate of stage Ⅱ wound repair in patients with diabetic foot.