封闭负压引流联合微动力负压敷料治疗糖尿病足溃疡的临床疗效分析

Clinical Efficacy Analysis of Vacuum Sealing Drainage Combined with Microdynamic Negative Pressure Dressing in the Treatment of Diabetic Foot Ulcers

目的 分析封闭负压引流(vacuum sealing drainage,VSD)联合微动力负压敷料修复糖尿病足创面的临床效果。方法 将2019年6月—2021年8月于鼓浪屿医院就诊的72例糖尿病足溃疡患者随机分为观察组(36例)和对照组(36例)。观察组予VSD联合微动力负压敷料治疗,对照组予VSD和普通敷料治疗。比较治疗前后两组患者的溃疡面积、溃疡面渗液血管内皮生长因子(vascular endothelial growth factor,VEGF)水平、疼痛视觉模拟评分法(Visual Analogue Acale,VAS)评分、溃疡愈合情况及不良反应发生率。结果 治疗前两组间溃疡面积、渗液VEGF水平及VAS评分,差异无统计学意义(P>0.05);治疗1周及2周后两组均出现溃疡面积减小、VAS评分下降、渗液VEGF水平升高,其中治疗2周后观察组溃疡面积小于对照组,治疗1周及2周后观察组VAS评分小于对照组,渗液VEGF水平高于对照组,差异有统计学意义(P<0.05)。随访至溃疡创面愈合,观察组换药次数少于对照组,愈合时间短于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 VSD联合微动力负压敷料能有效促进糖尿病足溃疡愈合、减轻局部疼痛,且不增加不良反应发生率。

Objective To analyze the clinical effect of vacuum sealing drainage(VSD) combined with microdynamic negative pressure dressing for repairing diabetic foot wounds.Methods 72 patients with diabetic foot ulcers who attended Gulangyu Hospital from June 2019 to August 2021 were randomly divided into an observation group(36 cases)and a control group(36 cases). The observation group was treated with VSD combined with microdynamic negative pressure dressing, and the control group was treated with VSD and plain dressing. The ulcer area, vascular endothelial growth factor(VEGF) level, Visual Analogue Scale(VAS) score of pain, ulcer healing and the incidence of adverse reactions were compared between the two groups before and after treatment.Results Before treatment, there were no statistically significant differences in ulcer area, VEGF level and VAS score between the two groups(P>0.05);after 1week and 2 weeks of treatment, both groups showed decreased ulcer area, decreased VAS score and increased VEGF level in exudative fluid;after 2 weeks of treatment, the ulcer area in the observation group was smaller than that in the control group;after 1 week and 2 weeks of treatment, the VAS score in the observation group was smaller than that in the control group, and the VEGF level in exudative fluid was higher than that in the control group, the difference was statistically significant(P<0.05). Follow-up to ulcer wound healing, the observation group was less than control group dressing times, healing time was shorter than control group, the difference was statistically significant(P<0.05). There was nos tatistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion VSD combined with microdynamic negative pressure dressing can effectively promote the healing of diabetic foot ulcers and reduce local pain without increasing the incidence of adverse reactions.