脉冲清创在糖尿病足溃疡患者伤口愈合中的应用

Application of pulsatile lavage in wound healing of diabetic foot ulcer patients

目的探讨脉冲清创在糖尿病足溃疡患者伤口愈合中的应用效果。方法采用随机数字表法将86例糖尿病足溃疡患者分为2组,每组各43例,对照组采用常规方法消毒并清洁伤口,试验组采用封闭式脉冲冲洗集污组件装置冲洗伤口,2组伤口按照统一的方法清创、选择敷料并包扎伤口,观察2组患者换药次数、换药时间、疗效、换药费用、伤口疼痛评分及创面愈合情况。结果试验组换药次数、换药时间、伤口愈合时间和总有效率分别为(10.42±1.92)次、(12.19±2.37)min、(32.53±6.91)d、86.04%(37/43),对照组分别为(19.47±3.13)次、(21.65±3.99)min、(43.17±13.72)d、51.16%(22/43),差异有统计学意义(t值为4.545~16.127,χ2=13.214,均P<0.01),但试验组换药费用为(3278.78±220.92)元,对照组为(3195.75±206.54)元,2组比较差异无统计学意义(t值为-1.814,P>0.05),试验组干预后第2、4、6和8周的疼痛评分分别为(1.47±1.09)、(0.57±0.72)、(0.06±0.23)、(0.03±0.01)分,对照组分别为(3.83±1.16)、(2.73±1.41)、(1.92±1.06)、(1.43±0.70)分,2组差异均有统计学意义(F时间=390.663、F组间=76.011、F交互=4.210,均P<0.01),试验组干预后第2、4、6和8周的创面愈合率分别为(49.34±9.34)%、(86.26±13.33)%、(95.01±8.56)%、(97.28±3.62)%,对照组分别为(26.64±5.19)%、(50.37±10.53)%、(64.84±12.27)%、(72.04±12.96)%,2组比较差异有统计学意义(F时间=354.487、F组间=921.230、F交互=23.154,均P<0.01)。结论脉冲清创可以有效地清洁糖尿病足溃疡患者的伤口,减少换药次数,缩短每次换药时间和伤口愈合时间,减轻伤口疼痛,提高足溃疡创面的愈合率,且不增加患者的经济负担,值得临床推广应用。

Objective To explore the effect of pulsatile lavage on wound healing in diabetic foot ulcer patients.Methods The random number table method was used to divide 86 patients of diabetic foot ulcers into two groups with 43 patients in each group.The control group disinfected and cleaned the wound by routine methods,while the experimental group received closed pulse irrigation with sewage collection unit.The two groups were debridement,dressing selection and wound dressing in a unified way.The frequency of dressing change,time of dressing change,efficacy,cost of dressing changes,score of wound pain and wound healing were observed.Results The frequency of dressing change,dressing change time,wound healing time and total effective rate of the experimental group were(10.42±1.92)times,(12.19±2.37)min,(32.53±6.91)d and 86.04%(37/43),respectively,while those of the control group were(19.47±3.13)times,(21.65±3.99)min,(43.17±13.72)d and 51.16%(22/43),with statistically significant differences(t values were 4.545-16.127,χ2 value was 13.214,all P<0.01).However,the cost of dressing change in the experimental group was(3278.78±220.92)yuan,and that in the control group was(3195.75±206.54)yuan.There was no significant difference between the two groups(t value was-1.814,P>0.05).The pain scores were(1.47±1.09),(0.57±0.72),(0.06±0.23),(0.003±0.01)points in the experimental group at the 2nd week,the 4th week,the 6th week and the 8th week after intervention,and they were(3.83±1.16),(2.73±1.41),(1.92±1.06),(1.43±0.70)points respectively in the control group,the differences were statistically significant(Ftime=390.663,Fintergroup=76.011,Finteraction=4.210,all P<0.01).The wound healing rates were(49.34±9.34)%,(86.26±13.33)%,(95.01±8.56)%,(97.28±3.62)%respectively in the experimental group in the 2nd week,the 4th week,the 6th week and the 8th week after intervention,while in the control group they were(26.64±5.19)%,(50.37±10.53)%,(64.84±12.27)%and(72.04±12.96)%.The differences between the two groups were statistically significant(Ftime=354.487,Fintergroup=921.230,Finteraction=23.154,all P<0.01).Conclusions Pulsatile lavage can effectively clean the wound,reduce the frequency of dressing change,shorten the time of dressing change and wound healing,reduce the wound pain,improve the wound healing rate of diabetic foot ulcers,and did not increase the economic burden of patients,which was worthy of clinical application.