超声清创术联合中药灌洗负压技术治疗湿热型糖尿病足创面的临床观察

Clinical Observation on Ultrasonic Debridement Combined with Chinese Medicine Lavage and Negative Pressure Technique in the Treatment of Dampness-heat Diabetic Foot Wound

目的观察超声清创术联合中药(解毒洗剂)灌洗负压技术治疗湿热型糖尿病足创面的临床疗效。方法采用随机数字表法将58例住院的湿热型糖尿病足患者,分为观察组30例和对照组28例。观察组应用超声清创术联合中药(解毒洗剂)灌洗负压技术治疗,对照组应用超声清创术联合中药(解毒洗剂)常规换药治疗。比较2组患者的临床疗效,创面面积变化,创面症状体征(肉芽组织颜色及形态、气味、分泌物、创周红肿、疼痛)积分变化以及炎性指标(CRP、WBC、NE%)积分的变化情况。结果 2组的有效率对比,差异有统计学意义(P<0.05);观察组治疗后的症状体征积分、创面面积及炎性指标均低于对照组治疗后(P<0.05);且2组患者均未见明显不良反应。结论超声清创术联合中药灌洗负压技术对湿热型糖尿病足创面的愈合有较好的促进作用,可明显促进肉芽组织生长、减轻异味、减少分泌物、减轻创周红肿及缓解疼痛,值得临床推广及应用。

Objective To observe the clinical efficacy of ultrasonic debridement combined with traditional Chinese medicine detoxification lotion lavage negative pressure technique in the treatment of dampness-heat diabetic foot wounds.Methods A total of 58 patients with diabetic foot admitted to the hospital were enrolled in the study and randomly divided into two groups,with 30 in the observation group and 28 in the control group.The observation group was treated with ultrasonic debridement combined with traditional Chinese medicine(detoxification lotion)and negative pressure technique.The control group was treated with ultrasonic debridement combined with conventional Chinese medicine detoxification lotion gauze dressing and application.The effective rate of the two groups of patients,changes in wound area,changes in wound symptoms and signs(granulation tissue color and morphology,secretions,odor,pain,peri-inflammation),and changes in inflammatory markers(CRP,WBC,NE%)were observed.Results The effective rate of the two groups was statistically significant(P<0.05).The scores of the symptoms or signs,wound area and inflammatory indexes of the observation group were lower than those of the control group(P<0.05).No significant adverse reactions were observed in either group.Conclusion Ultrasonic debridement combined with Chinese medicine lavage negative pressure technology can promote the healing of dampness-heat type diabetic foot wounds,which can promote the growth of granulation tissue,reduce pus,relieve pain,reduce odor and redness and reduce infection.It is worthy of clinical promotion and application.