电火针洞式引流术在糖尿病足治疗中的应用

The application of annular drainage with electric pyropuncture needle for treatment of patients with diabeticfoot

目的评价电火针洞式引流术在糖尿病足治疗中的临床效果。方法采用回顾性分析方法，将2006年7月至2010年7月本院收治的100例糖尿病足患者按治疗方法分为传统引流术组和电火针洞式引流术组，每组50例。分别采取传统引流术和电火针洞式引流术治疗，治疗后分别从血糖控制情况、住院时间、伤口愈合时间、截肢率及不同Wagner分级伤口最终愈合位置与切口之间的距离、伤口扩散范围等方面比较电火针洞式引流术组与传统引流术组的差异。结果传统引流术组和电火针洞式引流术组患者治疗期间血糖水平（mmol／L）控制均较理想（7．76±1．41比7．38±1．40，P〉0．05）；传统引流术组住院时间（d：108±21比75±16）和伤口愈合时间（d：127±21比91±16）均较电火针洞式引流术组明显延长（均P〈0．01）；电火针洞式引流术组截肢率较传统引流术组明显降低（6％比20％，P〈0．05）。电火针洞式引流术组伤口最终愈合位置与切口之间距离（cm）较传统引流术组明显缩短（2级：1．26±0．40比4．27±1．02，3级：4．26±1.05比10．35±2．51，均P〈0．01）；随着Wagner分级程度的提高，患者伤口最终愈合位置与切口之间的距离、伤口扩散范围均逐渐增大；2-3级电火针洞式引流术组伤口扩散范围（cm^2。）较传统引流术组明显缩小（2级：1．27±0．56比7．08±2．59，3级：5．41±2．27比13．36±3．71，P〈0．01和P〈0．05），4级两组比较差异无统计学意义（12．50±2．52比34．25±4．35，P〉0．05）。结论电火针洞式引流术不仅引流充分，而且可以在糖尿病足伤口周围形成“护坊”，为防止糖尿病足进一步恶化提供了生物屏障。

Objective To evaluate the effect of annular drainage with electric pyropuncture needle for treatment of patients with diabetic foot. Methods From July 2006 to July 2010, 100 patients with diabetic foot treated by traditional drainage or annular drainage with electric pyropuneture were retrospectively analyzed, and they were divided into traditional drainage group （traditional group） and annular drainage with electric pyropuncture needle group （annular group, each 50 cases）. After treatment, the levels of blood glucose, the length of stay in hospital, wound healing time and amputation rate, different grades of Wagner classification and the range of ulcer spread were compared between the two groups. Results During treatment, the control of blood glucose in the two groups were good （mmol/L ： 7.76±1.41 vs. 7.38±1.40, P〉0.05）, the length of stay in hospital （day ： 108±21 vs. 75±16） and wound healing time （day ： 127±21 vs. 91± 16）in traditional group were longer markedly than those of the annular group （both P〈0.01 ）. The amputation rate in the annular group was lower significantly than that in the traditional group （6% vs. 20%, P〈0.05）. The length （cm） between the final healing position and the original incision in annular group was obviously shorter than that in traditional group （grade 2 ： 1.26±0.40 vs. 4.27±1.02, grade 3：4.26±1.05 vs. 10.35±2.51, both P〈0.01）. Along with the elevation of grade in Wanger classification, the final healing position and original incision and the range of wound spread enlarged, however, the range of spread （cm^2） in grades 2-3 in annular group contracted obviously compared with that in traditional group （grade 2 ： 1.27±0.56 vs. 7.08±2.59, grade 3 ： 5.41±2.27 vs. 13.36±3.71, P〈0.05 and P〈0.01）, but the comparison of grade 4 between the two groups had no statistical significant difference （12.50±2.52 vs. 34.25±4.35, P〉0.05）. Conclusion The annular drainage with electric pyropuncture needle not only can drain the abscess sufficiently well, but also can form a ＂defending field＂ as a biological barrier around the wound to prevent further deterioration of the diabetic foot.