低压力负压治疗糖尿病缺血性足溃疡的临床研究

Clinical Study on Low-pressure Negative Pressure in Treatment of Ischemia Diabetic Foot

目的:观察低压力负压治疗中度缺血的糖尿病足溃疡的效果。方法:选择中度缺血的糖尿病足溃疡患者160例,均进行系统的内科治疗。按随机数字表法分为观察组120例,对照组40例。观察组分为3个亚组,分别采用120mmHg、90mmHg、60mmHg负压治疗(间歇模式),每组各40例,以比较常规负压治疗与低压力负压治疗的疗效差异。对照组采用常规换药治疗。记录治疗2周、4周后伤口面积、局部症状积分及治疗过程的疼痛评分。结果:治疗2周、4周时,观察组效果优于对照组(P<0.05);3个亚组之间,伤口面积和局部症状积分方面无统计学差异(P>0.05)。疼痛评分方面,60mmHg负压治疗组疼痛评分最低,2周时(2.76±2.75),4周时(2.25±2.21);90mmHg负压治疗组次之,2周时(3.75±3.01),4周时(3.88±2.59);120负压治疗组疼痛评分最高,2周时(5.13±2.64),4周时(4.38±2.92);差异有统计学意义(P<0.05)。在治疗期间各组不良反应无明显差异(P>0.05)。60mmHg负压治疗组为本次研究的最优治疗方案。结论:低压力负压治疗糖尿病缺血性足溃疡,疗效确切,可以有效促进伤口愈合,减轻患者疼痛。

Objective To observe the effect of low-pressure negative pressure therapy on diabetic foot ulcer with moderate ischemia.Methods Totally 160 patients with diabetic foot ulcer with moderate ischemia were selected and divided into observation group(120 cases)and control group(40 cases)by digital table method.The patients in observation group were divided into three subgroups.The patients were treated with 120 mmHg,90 mmHg and 60 mmHg negative pressure(intermittent mode),40 cases in each group,to compare the efficacy of conventional negative pressure therapy with that of low pressure negative pressure therapy.The patients in control group were treated with routine dressing change.Wound area,local symptom score and pain score were recorded after 2 and 4 weeks of treatment.Results After 2 and 4 weeks of treatment,the effect of observation group was better than that of control group(P<0.05).There was no statistical difference in wound area and local symptom score among the three subgroups(P>0.05).In pain score,the 60 mmHg negative pressure group had the lowest pain score(2 weeks of 2.76±2.75,4 weeks of 2.25±2.21),followed by 90 mmHg negative pressure group(2 weeks of 3.75±3.01,4 weeks of 3.88±2.59).The pain score of 120 negative pressure group was the highest(2 weeks of 5.13±2.64,4 weeks of 4.38±2.92).The difference was significant(P<0.05).There was no significant difference in adverse reactions among groups during treatment(P>0.05).The 60 mmHg negative pressure treatment group was the optimal treatment for this study.Conclusion Low-pressure negative pressure therapy is effective in treating diabetic ischemic foot ulcer.It can effectively promote wound healing and relieve pain of patients.It is worthy of clinical application.