横向骨搬移技术联合PRP对糖尿病足溃疡患者修复效果及生活质量的影响

Effect of Transverse Bone Transfer Technique Combined with PRP on Repairing Effect and Quality of Life in Patients with Diabetic Foot Ulcer

目的:探讨横向骨搬移技术联合自体富血小板血浆对糖尿病足溃疡患者创面修复效果及生活质量影响。方法:选取2018年1月至2018年10月我院收治并确诊糖尿病足患者134例,随机分为观察组与对照组,每组67例。对照组清创后以PRP外敷创面,观察组给以PRP外敷创面联合胫骨横向骨搬移术治疗。比较两组糖尿病足溃疡患者创面肉芽组织中血小板源性生长因子蛋白受体(PDGFR)的表达变化、创面缩小率、细菌清除率、肉芽组织覆盖率、肉芽组织厚度以及生活质量。结果:治疗前,两组的PDGFR-α和PDGFR-β含量差异无统计学意义(P>0.05)。治疗后,两组的PDGFR-α和PDGFR-β含量较治疗前均增多,且观察组较对照组增多更为显著,差异有统计学意义(P<0.01)。观察组的创面缩小率明显大于对照组,细菌清除率及肉芽组织覆盖率显著高于对照组,以及肉芽组织生长厚度明显厚于对照组,差异均有统计学意义(P<0.01)。治疗后,两组的治疗影响、心理或精神、生理功能、社会关系4个维度分值均降低,且观察组的降低幅度大于对照组,差异有统计学意义(P<0.01)。结论:横向骨搬移技术与PRP联合治疗DFU,可有效提高血小板源性生长因子蛋白受体表达,提高溃疡创面的修复效果,改善生活质量。

Objective: To investigate the effect of transverse bone transfer technique combined with PRP on repairing effect and quality of life in patients with diabetic foot ulcer . Methods: 134 patients with diabetic foot from January 2018 to October 2018 were chosen and divided into observation group and control group ,67 cases in each group . The control group was treated with PRP topical wound after debridement ,the observation group was treated with PRP external wound combined with transverse tibial bone transport . Compare the expression changes of PDGFR ,wound reduction rate ,bacterial clearance rate ,granulation tissue coverage ,granulation tissue thickness and quality of life between the two groups . Results: Before the treatment ,there was no significant difference in PDGFR-α and PDGFR-β between the two groups ( P>0.05 ). After treatment ,the levels of PDGFR-α and PDGFR-β in both groups were higher than before treatment ,and the observation group increased more significantly than the control group ,P<0.01 . The rate of wound reduction in the observation group was significantly higher than that in the control group ,the rate of bacterial clearance and the coverage rate of granulation tissue were significantly higher than that in the control group ,and the growth thickness of granulation tissue was significantly thicker than that in the control group ,P all <0.01 . After treatment ,the scores of treatment influence ,psychological or spiritual ,physiological function ,and social relationship of the two groups were reduced ,and the reduction of the observation group was greater than that of the control group ,P<0.01 . Conclusion: Transverse-bone transfer technique combined with PRP in the treatment of DFU can effectively improve the expression of PDGFR ,improve the repair effect of ulcer wounds ,and improve the quality of life.