蛆虫清创治疗在糖尿病足溃疡中的作用

Role of maggot debridement therapy in diabetic foot ulcers

糖尿病足是糖尿病并发症之一。丝光绿蝇的幼虫具有独特的生物学特性，只吃腐烂组织、对活体组织无影响，且能分泌蛋白水解酶，降解、液化伤口的坏死组织。蛆虫清创治疗（maggotdebridementtherapy，MDT）有500多年的历史，但直到1983年才重新在欧洲恢复使用，2004年获美国食品药品监督管理局（FDA）正式认可。在糖尿病足溃疡（DFUs）的治疗中，MDT可能通过不同的作用机制来完成清创作用、促进生长作用和抗感染作用。MDT适用于多种伤口的治疗，但不适用于容易出血伤口、与体腔或内部器官有联系的伤口或大血管附近的伤口。

Diabetic foot is one of the diabetic complications. Lucilia sericata has unique biological properties, eating rotten tissue and none of living tissue, secreting proteolytic enzyme which can degrade and liquify necrotic tissue. Maggot debridement therapy （MDT） has a 500-year history,and to regain attention in Europe till 1983, and not be admitted by FDA until 2004. The effect of MDT on diabetic foot ulcers（ DFUs ） includes three aspects by various mechanism, which are cleaning up the wounds, promoting growth and resis- ting bacteria. MDT can be used to treat many types of wound, but should not be applied to wounds that have a tendency to bleed easily, or that communicate with a body cavity or internal organ, and that near to any large blood vessels.