壳聚糖复合藻酸钙敷料治疗糖尿病足溃疡慢性感染的临床研究

Chitosan combined with calcium alginate dressing used in treatment of chronic ulcer infection of diabetic foot

目的:探讨壳聚糖复合藻酸钙敷料在糖尿病足慢性溃疡感染中的治疗作用。方法:选取2017年1月—2018年1月濮阳市人民医院创面愈合中心收治的糖尿病足慢性溃疡感染患者80例,随机分为复合组及对照组,每组40例。两组在创面清创基础上,对照组用单纯藻酸钙敷料换药治疗,复合组用壳聚糖复合藻酸钙敷料换药治疗。观察两组治疗效果,并进行组织学分析。结果:复合组创面感染控制时间、肉芽组织开始生长时间、创面渗液干净时间及创面愈合时间均明显低于对照组(P<0.05);复合组换药次数明显少于对照组(P<0.05);复合组治疗后疼痛评分明显低于对照组(P<0.05);两组治疗第15天时成纤维细胞及新生毛细血管数量均明显低于第7天(P<0.05);治疗第7天复合组成纤维细胞、新生毛细血管数量明显高于对照组(P<0.05);治疗第15天复合组时成纤维细胞、新生毛细血管数量明显低于对照组(P<0.05)。结论:壳聚糖复合藻酸钙敷料用于糖尿病足慢性溃疡感染治疗,能够有效控制创面感染,促进创面愈合,减轻疼痛,值得临床推广使用。

Objective: To investigate the therapeutic effect of chitosan combined with calcium alginate dressing in treatment of chronic ulcer infection of diabetic foot. Methods: Eighty patients with chronic ulcer infection of diabetic foot, admitted to the Wound Healing Center of Puyang People's Hospital from Jan. 2017 to Jan. 2018, were selected and randomly divided into composite group and control group (40 each). Patients in both groups received debridement. Then, the control group was treated with calcium alginate dressing alone, and the composite group was treated using chitosan combined with calcium alginate dressing. The curative effects and histological changes of the two groups were observed and analyzed. Results: The time of controlling wounds infection , the time when granulation tissue begins to grow, the time of wound seepage cleaning, and the healing time of wound were obviously lower in composite group than in control group (P<0.05). The frequency of dressing changes was markedly less and the pain score after treatment was significantly lower in composite group than in control group (P<0.05). The number of fibroblasts and new capillaries in both groups was significantly less at day 15 than at day 7 after treatment (P<0.05), and was significantly higher in composite group than in control group at day 7 after treatment (P<0.05), while was significantly less in composite group than in control group at day 15 after treatment (P<0.05). Conclusions: Chitosan combined with calcium alginate dressing, used in treatment of diabetic foot chronic ulcer infection, may effectively control the wound infection, promote the wound healing and reduce pain, so is worthy of clinical application.