超声水刀清创系统联合封闭式负压引流冲洗在慢性糖尿病足创面治疗中的应用

Application of Ultrasonic Waterjet Debridement System Combined with Vacuum Sealing Drainage in the Treatment of Chronic Diabetic Foot Wounds

目的探究超声水刀清创系统联合封闭式负压引流(VSD)冲洗在慢性糖尿病足创面治疗中的应用效果。方法选取2017年1月—2019年12月诊治的86例慢性糖尿病足患者为研究对象,根据非随机临床同期对照研究及患者自愿原则,分为对照组(VSD冲洗)和观察组(超声水刀清创系统联合VSD冲洗),每组43例。比较2组治疗效果、创面愈合时间、换药次数以及并发症发生率,同时观察治疗前后2组的踝/肱血压指数(ABI)、足背部动脉血流最快流速、最慢流速、阻力系数。结果观察组总有效率高于对照组,创面愈合时间短于对照组,换药次数少于对照组(P<0.05);治疗后,2组足背部动脉血流最快流速、最慢流速以及ABI与治疗前比较明显升高,且观察组高于对照组(P<0.05);治疗后,2组阻力系数与治疗前比较明显减小,且观察组小于对照组(P<0.05)。2组并发症总发生率比较差异无统计学意义(P>0.05)。结论超声水刀清创系统联合VSD冲洗治疗可明显提高慢性糖尿病足患者的临床效果,能有效改善创面组织血流灌注及动脉血液循环,在促进患者创面愈合中有积极意义。

Objective To investigate the application effect of ultrasonic waterjet debridement system combined with vacuum sealing drainage(VSD)in the treatment of chronic diabetic foot wounds.Methods Eighty-six patients with chronic diabetic foot diagnosed and treated between January 2017 and December 2019 were selected as the research subjects.According to the non-randomized clinical controlled study and the voluntary principle,they were divided into control group(VSD irrigation)and observation group(ultrasonic waterjet debridement system combined with VSD irrigation),with 43 cases in each group.The treatment effect,wound healing time,dressing change times and complication rate of the two groups were compared,and the ankle-brachial index(ABI),and the fastest flow rate,the slowest flow rate and the resistance coefficient of blood flow in the dorsal pedal arteries in the two groups were observed before and after treatment.Results The total effective rate of the observation group was higher than that of the control group,the wound healing time was shorter than that of the control group,and the dressing change times were less than those of the control group(P<0.05).After treatment,the fastest flow rate,the slowest flow rate and ABI of blood flow of the dorsal pedal arteries in the two groups were significantly higher than those before treatment,and the indexes in the observation group was higher than those in the control group(P<0.05).After treatment,the resistance coefficient of the two groups was significantly reduced compared with that before treatment,and the index in the observation group was smaller than that in the control group(P<0.05).There was no significant difference in the total incidence rate of complications between the two groups(P>0.05).Conclusion Ultrasonic waterjet debridement system combined with VSD irrigation can significantly improve the clinical effect of chronic diabetic foot patients,effectively improve the blood perfusion of wound tissue and arterial blood circulation,and has a positive significance in promoting wound healing of patients.