自体富血小板凝胶治疗不同治疗周期中糖尿病足溃疡的临床评价

Clinical effect of autologous platelet-rich gel in treating diabetic foot ulcers with different treatment cycles

目的探讨不同治疗周期下自体富血小板凝胶(APG)对糖尿病足溃疡(DFU)的治疗效果。方法 2014年12月至2016年12月在重庆市中医院就诊的120例DFU患者,随机分为1次/周组、1次/2周组和1次/3周组进行APG治疗。比较各组不同时间节点(2、4、6周)的临床疗效、创面愈合率及患者溃疡显效的时间。结果各组总有效率均为100%,但在不同时间节点临床疗效比较,差异有统计学意义,尤其在4周和6周治疗后,1次/周组和1次/2周组显效和痊愈的数量优于1次/3周组(P<0.05)。6周治疗后,1次/周组溃疡愈合率为(96.12±3.74)%,1次/2周组为(96.60±2.39)%,1次/3周组为(90.81±4.74)%,差异有统计学意义(P<0.01)。溃疡显效时间方面,1次/周组为(25.90±5.13)d,1次/2周组为(24.75±5.06)d,少于1次/3周组的(32.85±6.91)d(P<0.01)。1次/周组与1次/2周组各项评价指标差异无统计学意义(P>0.05)。结论 APG治疗DFU能够缩短创面愈合时间;考虑到患者治疗费用等情况,1次/2周APG治疗能够获得最大的投入产出比。

Objective To explore the clinical effect of autologous platelet-rich gel （APG） in treating diabetic foot ulcers （DFU） between different treatment cycles. Methods A total of 120 DFU patients were randomly divided into three groups with APG treatment, including 1 time/week group, 1 time/2 weeks group and 1 time/3 weeks group,respectively. The clinical efficacy, wound healing rate and the time for effective response in each group at different time points （2,4 and 6 weeks） were compared. Results The total effective rate in three groups were 100%. However, the clinical efficacy was different among three groups at different time points. The number of effective response and cured patients in 1 time/week group and 1 time/2 weeks group was significantly higher than that in 1 time/3 weeks group, especially after 4 weeks and 6 weeks of APG treatment. The wound healing rate in 1 time/week group and 1 time/2 weeks group accounted for （96.12±3.74）% and （96.60±2. 39）%,which much higher than that in 1 time/3 weeks group （90. 81±4.74）% （P〈0.01）. The time for effective DFU response in three groups was （25.90±5.13）, （24. 75 ± 5.06） and （32.85 ± 6.91） day, respectively （P〈0. 01）. There was no significant difference in evaluation indexes between 1 time/week group and 1 time/2 weeks group （P〉 0. 05）. Conclusion Treatment with APG in DFU patients can shorten the wound healing time. Taking into account the costs of treatment and other conditions, 1 time/2 weeks APG treatment can get the maximum input-output ratio.