持续负压封闭引流对糖尿病足病人神经传导及氧化应激的影响

Effect of continued vacuum sealing drainage on nerve conduction and oxidative stress in diabetic foot patients

目的:探讨持续负压封闭引流对糖尿病足病人神经传导及氧化应激的影响。方法:选择糖尿病足病人70例,随机分为对照组和观察组,各35例,所有病人均采用降糖等常规治疗,对照组病人在此基础上给予降纤酶治疗,观察组病人给予持续负压封闭引流治疗,比较2组病人治疗总有效率和不良反应发生率,治疗前后运动神经传导速度(MCV)和感觉神经传导速度(SCV)以及血流速度、抗氧化超氧阴离子自由基(Anti-O^(2-))活力、超氧化物歧化酶(SOD)活性、一氧化氮(NO)含量、脂质过氧化物丙二醛(MDA)水平、总一氧化氮合成酶(TNOS)的含量和诱导型一氧化氮合成酶(iNOS)含量。结果:观察组病人总有效率为94.29%,高于对照组的77.14%(P<0.05);2组病人MCV和SCV均有所增加(P<0.05～P<0.01),且观察组MCV和SCV均高于对照组(P<0.05);2组治疗后血浆iNOS和MDA水平均升高(P<0.05～P<0.01),SOD、Anti-O^(2-)、NO和TNOS水平均降低(P<0.05～P<0.01),但2组iNOS、MDA升高和SOD、Anti-O^(2-)、NO、TNOS下降水平差异均无统计学意义(P>0.05);观察组治疗后血流速度高于对照组(P<0.01)。对照组治疗期间不良反应率为14.29%,与观察组的8.57%差异无统计学意义(P>0.05)。结论:持续负压封闭引流能够改善神经传导功能,促进足部溃疡愈合,且不会显著加重病人体内应激反应,临床效果较好,值得推广应用。

Objective:To explore the effects of continued vacuum sealing drainage on nerve conduction and oxidative stress in diabetic foot patients.Methods:Seventy patients with diabetic foot were randomly divided into the control group and observation group(35 cases each group).The control group was treated with conventional method combined with defibrase,and the observation group was treated with continued vacuum sealing drainage based on the conventional treatment.The total effective rate,adverse reaction rate,motor nerve conduction velocity(MCV),sensory nerve conduction velocity(SCV),artery blood flow velocity,antioxidant superoxide anion free radical(Anti-O^2-)activity,activity of superoxide dismutase(SOD),nitric oxide(NO)content,level of malondialdehyde(MDA),total content of nitric oxide synthase(TNOS)and inducible nitric oxide synthase(iNOS)level between two groups were compared before and after treatment.Results:The clinical total effective rate in observation group(94.29%)was significantly higher than that in control group(77.14%)(P<0.05).The MCV and SCV in two groups increased(P<0.05 to P<0.01),and which in observation group was higher than that in control group(P<0.05).After treatment,the plasma levels of iNOS and MDA increased(P<0.05 to P<0.01),the levels of SOD,Anti-O^2-,NO and TNOS decreased(P<0.05 to P<0.01),and the differences of the increasing and decreasing degrees of those between two groups were not statistically significant(P>0.05).After treatment,the blood flow velocity in observation group was higher than that in control group(P<0.01).The incidence rates of adverse reaction in observation group and control group were 14.29%and 8.57%,respectively,and the difference of which was not statistically significant(P>0.05).Conclusions:Continued vacuum sealing drainage in the treatment of diabetic foot patients can improve the nerve conduction velocity,promote the healing of foot ulcers,and do not significantly aggravate the oxidative stress reaction of patients,which is worthy of clinical application.