Masquelet技术治疗糖尿病足的临床观察

Clinical observation of Masquelet technique in the treatment of diabetes foot

目的 探讨Masquelet技术治疗糖尿病足病的方法和疗效。方法 2020年1月至2021年12月本院80例糖尿病足病患者中应用Masquelet诱导膜技术治疗20例,在血糖控制基础上一期彻底清创后植入骨水泥,2~3周后手术取出骨水泥,保护诱导膜完整性以可吸收线直接缝合或创面植皮修复。比较手术前后血沉(ESR)、C反应蛋白(CRP)、白细胞(WBC)、白蛋白情况。结果 本组均获得2月至2年随访,继发性溃疡2例(均为Wagner 4级),其中足部截肢平面增高1例。术前与术后ESR、CRP、WBC、白蛋白相比较,差异有统计学意义。结论 糖尿病足病经Masquelet技术治疗效果良好,操作简单,但对清创要求高,可提高糖尿病足保肢水平,值得推广。

Objective To investigate the method and efficacy of Masquelet technology in the treatment of diabetes foot disease. Methods From January 2020 to December 2021, 20 of 80 patients with diabetes foot disease in our hospital were treated with Masquelet technology. On the ba-sis of controlling blood glucose, bone cement was implanted after thorough debridement in one stage. After 2-3 weeks, the bone cement was removed surgically. Under the premise of protecting the integrity of the induction membrane, absorbable suture or skin graft was used to repair the wound. ESR,CRP, WBC and albumin were compared before and after operation. Results All patients were followed up for 2 months to 2 years. There were 2cases of secondary ulcer(all of them were Wagner grade 4), including 1 case with elevated amputation level. There were significant differences in ESR, CRP, WBC and albumin before and after operation. Conclusion Masquelet technology has a good effect on treating diabetes foot with simple operation, but it requires high quality of debridement and can improve the level of limb salvage in diabetes foot, which is worth popularizing.