高压氧联合西洛他唑治疗糖尿病足的临床研究

Clinical study on hyperbaric oxygen combined with cilostazol foot in treating diabetic foot

目的探讨高压氧联合西洛他唑治疗糖尿病足的临床价值。方法选取2014年6月至2016年7月该院确诊为糖尿病足患者90例,采用随机数字表法分为观察组和对照组,每组各45例。对照组在基础治疗基础上给予西洛他唑治疗,观察组在对照组基础上加用高压氧治疗。观察两组临床疗效,以及血液流变学、血液指标和血浆纤溶指标变化。结果观察组治疗总有效率(91.11%)明显高于对照组(71.11%),差异有统计学意义(P<0.05);观察组治疗后全血黏度(高切、低切)、红细胞比容明显低于对照组(P<0.05);观察组治疗后糖化血红蛋白(HbA1c)、同型半胱氨酸(Hcy)和超敏C反应蛋白(hs-CRP)水平明显低于对照组(P<0.05);观察组治疗后纤维蛋白原、组织型纤溶酶原激活物水平明显优于对照组(P<0.05)。结论高压氧联合西洛他唑能有效改善糖尿病足患者HbA1c、Hcy、hs-CRP水平,促进创面愈合,提高临床治疗效果。

Objective To study the clinicalvalue of hyperbaric oxygen combined with cilostazol in treating diabetic foot.Methods 90 patients with diabetic foot in our hospital from June 2014 to July 2016 were selected and randomly divided into the observation group and control group according to the random number table method,45 cases in each group.The control group was given the cilostazol treatment on the basis of basic treatment,while on the basis of control group treatment,the observation group was added with the hyperbaric oxygen therapy.The clinical efficacy and the changes of hemorheology,blood parameters and plasma fibrinolytic indicators of the two groups were observed.Results The total effective rate in the observation group was 91.11%,which was significantly higher than 71.11%in the control group,the difference was statistically significant（P0.05）;the whole blood viscosity（high shear and low shear）,hematocrit after treatment in the observation group were significantly lower than those in the control group（P0.05）;the levels of HbA1 c,homocysteine（Hcy）and plasma high-sensitivity C reactive protein（hs-CRP）after treatment in the observation group were significantly lower than those in the control group（P0.05）,the levels of plasma fibrinogen andtissue-type plasminogen activator（TPA）after treatment in the observation group were significantly superior to those in the control group（P0.05）.Conclusion Hyperbaric oxygen combined with cilostazol can effectively improve the levels of HbA1 c,Hcy and hs-CRP in thee patients with diabetic foot,promotesthe wound healing and improves the clinical treatment effect.