高糖胰岛素混合液对Ⅱ～Ⅲ期压疮局部治疗有效性的研究

Clinical Efficacy of High-glucose Insulin Mixture on the Local Treatment of Grade Ⅱ and Ⅲ Pressure Ulcers

目的探讨高糖胰岛素混合液在Ⅱ~Ⅲ期压疮患者局部治疗中的有效性。方法将2011年1月-2012年6月入选的124例Ⅱ~Ⅲ期压疮患者随机分为3组：生理盐水组（41例）、高糖胰岛素组（41例）和现代敷料组（42例）。换药1周后采用传统评定标准和压疮愈合评价量表（PUSH）两种方法评价患者的治疗效果。结果按传统评定标准,3组总有效率分别为53.7%、90.2%和97.6%,差异有统计学意义（χ2=30.453,P〈0.001）;按PUSH评分,3组治疗前差异无统计学意义（F=0.014,P=0.986）,治疗后评分分别为（6.02±4.98）、（3.15±3.66）、（2.43±2.95）分,差异有统计学意义（F=9.600,P〈0.001）。按两种评价方法,高糖胰岛素组和现代敷料组分别与生理盐水组比较差异均有统计学意义（P〈0.01）,而高糖胰岛素组和现代敷料组比较差异则无统计学意义（P〉0.05）。分别对Ⅱ期或Ⅲ期压疮患者进行亚组分析的结果也表明：高糖胰岛素组和现代敷料组的治疗效果均明显优于生理盐水组（P〈0.01）,而高糖胰岛素组和现代敷料组之间的治疗效果无明显差异（P〉0.05）。结论高糖胰岛素混合液和现代敷料对Ⅱ、Ⅲ期压疮患者均具有良好的效果,但高糖胰岛素混合液成本低廉,值得临床广泛推广。

Objective To investigate the clinical effectiveness of high-glucose insulin mixture on the local treatment of patients with grade Ⅱ and Ⅲ pressure ulcers. Methods A total of 124 patients with grade Ⅱ and Ⅲ pressure ulcers treated between January 2011 and June 2012 were randomly divided into three groups： saline group （group A, n=41）, high- glucose insulin mixture group （group B, n=41） and modem dressing group （group C, n=42）. We observed and compared the treatment effects among the three groups using both measurements of traditional evaluation criteria and pressure ulcer scale for healing （PUSH） after a week of dressing. Results The overall treatment effects among the three groups were significantly different （2,z=30.453, P 〈 0.001）. The results of pairwise comparisons was that the treatment effect was significantly different between group B or C and group A （P 〈 0.01）, but the treatment effect was not statistically different between group B and C （P 〉 0.05）. Subgroup analysis for patients with grade Ⅱ or Ⅲ pressure deers also came to the similar results. Conclusions Both high-glucose insulin mixture and modem dressing have significant effects on patients with grade Ⅱ and Ⅲ pressure ulcers. However, the high-glucose insulin mixture costs less and is worthy of extensive promotion.