皮肤再生医疗技术结合VSD治疗老年Wagner 3级糖尿病足溃疡的效果观察

Effect of skin regeneration medical technique combined with VSD on Wagner grade 3 diabetic foot ulcer in elderly patients

目的观察皮肤再生医疗技术结合封闭负压引流技术(VSD)治疗老年Wagner 3级糖尿病足溃疡(DFU)对创面组织中晚期糖基化终末产物(AGEs)、β-连环素(β-catenin)表达及创面美观度的影响。方法抽取2020年1月至2022年1月洛阳市中心医院收治的Wagner 3级DFU老年患者92例,按随机数字表法分为对照组和观察组,每组46例。对照组给予VSD治疗,观察组在对照组基础上给予皮肤再生医疗技术治疗。比较两组临床疗效、创面愈合情况、炎性因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)],创面组织AGEs、β-catenin表达及创面美观满意度。结果观察组治疗有效率(95.65%,44/46)高于对照组(76.09%,35/46),P<0.05。观察组肉芽组织形成、创面愈合及住院时间均短于对照组(P均<0.05)。治疗后,两组血清TNF-α、IL-6、CRP水平及创面组织中AGEs表达均降低,创面组织中β-catenin表达均升高(P均<0.05),且观察组血清TNF-α、IL-6、CRP水平及创面组织中AGEs表达均低于对照组,创面组织中β-catenin表达高于对照组(P<0.05)。观察组创面美观满意度(97.83%,45/46)高于对照组(80.43%,37/46),P<0.05。结论皮肤再生医疗技术结合VSD可促进老年Wagner 3级DFU患者创面愈合,下调血清炎性因子水平,提高创面美观度。

Objective To observe the effect of skin regeneration medical technique combined with vacuum sealing drainage(VSD)on the expression of advanced glycation end products(AGEs)andβ-catenin in wound tissues,and effect on wound appearance in elderly patients with Wagner grade 3 diabetic foot ulcer(DFU).Methods Ninety-two elderly patients with Wagner grade 3 DFU treated in Luoyang Central Hospital from January 2020 to January 2022 were selected.The patients were divided into control group and observation group by random number table method,with 46 cases in each group.Patients in the control group were treated by VSD,while patients in the observation group were treated by skin regeneration medical technique combined with VSD.Clinical effects,wound healing,inflammatory factors including tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP),the expression of AGEs andβ-catenin in wound tissues,and satisfaction with wound appearance were compared between the two groups.Results The effective rate of treatment in the observation group(95.65%,44/46)was higher than that in the control group(76.09%,35/46),P<0.05.The appearance time of granulation tissue,wound healing time and hospital stay in the observation group were shorter than those in the control group(all P<0.05).After treatment,levels of serum TNF-α,IL-6 and CRP,and expression of AGEs in wound tissues decreased,while expression ofβ-catenin in wound tissues increased in the two groups(all P<0.05).Levels of serum TNF-α,IL-6 and CRP,and expression of AGEs in wound tissues of the observation group were significantly lower than those of the control group,and expression ofβ-catenin in wound tissues were significantly higher than those of the control group(P<0.05).The satisfaction rate of wound appearance in the observation group(97.83%,45/46)was higher than that in the control group(80.43%,37/46),P<0.05.Conclusions Skin regeneration medical technique combined with VSD can promote wound healing,lower levels of serum inflammatory factors,and improve wound appearance in elderly patients with Wagner grade 3 DFU.