封闭负压引流技术联合皮瓣移植术治疗糖尿病足溃疡效果观察

Effect Observation of Vacuum Sealing Drainage Combined with Flap Transplantation in the Treatment of Diabetic Foot Ulcer

目的探讨封闭负压引流技术(VSD)联合皮瓣移植术治疗糖尿病足溃疡的临床效果。方法选取糖尿病足溃疡128例作为研究对象,按照治疗方法不同将其分为观察组68例和对照组60例。观察组采用VSD联合皮瓣移植术治疗,对照组采用皮瓣移植术治疗。评定比较两组治疗前、治疗1周后、治疗2周后、治疗4周后溃疡面积及治疗结束后溃疡情况(溃疡创面愈合所需时间、肉芽组织形成所需时间和截肢率)、临床疗效,并记录两组并发症发生情况。结果治疗1、2及4周后观察组溃疡面积均小于对照组,差异有统计学意义(P <0. 05)。治疗结束后观察组溃疡创面愈合所需时间及肉芽组织形成所需时间均短于对照组,截肢率低于对照组,差异具有统计学意义(P <0. 05)。治疗结束后观察组临床总有效率88. 24%显著高于对照组临床总有效率56. 67%,差异具有统计学意义(P <0. 05)。两组治疗过程中及治疗结束后均未出现明显并发症。结论 VSD联合皮瓣移植术治疗糖尿病足溃疡临床有效率较高,可进一步促进溃疡创面的愈合和新鲜肉芽组织的形成,降低截肢率,且安全性较好。

Objective To explore the effect of vacuum sealing drainage combined with flap transplantation in the treatment of diabetic foot ulcer. Methods A total of 128 patients with diabetic foot ulcers in our hospital were selected as subjects. According to different treatment methods, they were divided into observation group （ n =68） and control group （ n =60）.The observation group was treated with vacuum sealing drainage （VSD） combined with skin flap transplantation, while the control group was treated with skin flap transplantation. The ulcer area, ulcer situation （time needed for ulcer healing and granulation tissue formation, and amputation rate） and clinical efficacy were evaluated and compared between the two groups before treatment at 1, 2 and 4 weeks after treatment. The complications of the two groups were recorded. Results The ulcer area of the observation group was smaller than that of the control group at 1, 2 and 4 weeks of treatment, and the difference was statistically significant （ P 〈0.05）. After treatment, the time needed for ulcer wound healing and granulation tissue formation in the observation group were shorter than those in the control group, and the amputation rate was lower than that in the control group, suggesting significant differences （ P 〈0.05）. After treatment, the total effective rate of 88.24% in the observation group was significantly higher than that of 56.67% in the control group, and the difference was statistically significant （ P 〈0.05）. No obvious complications occurred in the two groups during and after treatment. Conclusion VSD combined with skin flap transplantation for diabetic foot ulcer has a higher clinical effect, which can further promote ulcer wound healing and the formation of fresh granulation tissue, and reduce its amputation rate, as a safe approach.