超声清创术对糖尿病足溃疡创面细菌清除及微循环作用的临床研究

Effect of ultrasound debridement on bacteria cleaning and microcirculation improvement in diabetic foot ulcer

目的评价超声清创术对糖尿病足溃疡创面细菌的清除作用及对微循环的影响,探讨其可能的促愈机制。方法采用随机对照法将2008年5月至2009年2月住院的糖尿病足患者24例分为标准治疗+普通冲洗组(ST组)和标准治疗+超声清创组(SU组)各12例,分别对两组治疗20d内溃疡愈合速度、创面微循环改变及创面细菌清除作用进行比较。结果 (1)SU组第20天平均创面愈合速率[(0.87±0.11)%]显著快于ST组[(0.65±0.14)%](P<0.05)。(2)SU组治疗后创面平均血流灌注量[(0.91±0.18)PU]及经皮氧分压[(34.66±6.08)mmHg]显著高于ST组[(0.80±0.19)PU和(32.83±6.97)mmHg](P均<0.05)。(3)SU组治疗后创面细菌量显著少于ST组(P<0.05)。结论超声清创术可通过减轻伤口细菌负荷及促进创面微循环,而促进糖尿病足的伤口愈合。

Objective To evaluate the effect microcirculation improvement of diabetic foot ulcer. of ultrasound debridement on bacteria cleaning and Methods 24 patients with diabetic foot ulcer, who were hospitalized from May 2008 through February 2009, were randomized into standard therapy group （ST group, n=12）and standard therapy plus ultrasound debridement group （SU group,n= 12）. The speed of ulcer healing, microcirculation change of wound surface, bacteria on wound surface after 20 daystreatment were compared between the two groups. Results The healing rate of wound surface at 20 days of treatment was higher in SU group than in ST group（0.87±0.11% vs 0. 65±0.14% ,P〈0.05）. The blood perfusion volume of wound after treatment was larger in SU group than in ST group[（0.91±0.18） vs （0.80±0.19）PU, P〈0.05]. The transcutaneous oxygen pressure（mmHg）was higher in SU group than in ST group after treatment[（34.7±6.1） vs （32.8±7.0） ,P〈0.05]. The bacterial amount of wound was less in SU group than in ST group （P 〈 0.05） Conclusions Ultrasound debridement can promote the healing of diabetic foot ulcer through decreasing the bacterial load of wound surface and accelerating the mierocirculation of wound surface.