高压氧联合巴曲酶治疗WagnerⅢ级糖尿病足的疗效分析

Effectl analysis of hyperbaric oxygen combined with batroxobin in the treatment of WagnerⅢgrade diabetic foot

目的探讨高压氧(Hyperbaric oxygen,HBO)联合巴曲酶对WagnerⅢ级糖尿病足(Diabetic foot,DF)的治疗效果。方法回顾性分析2018年9月-2020年1月,大连医科大学附属二院骨与软组织修复重建外科收治的92例Wagner级糖尿病足患者临床资料,依据随机数字表法,分成对照组和观察组,每组各46例。所有患者入院后均行糖尿病足清创手术。术后,对照组糖尿病足创面进行常规换药治疗;观察组在对照组治疗的基础上,应用高压氧及巴曲酶联合治疗。比较两组在创面愈合率、血浆纤维蛋白原、血液粘稠度、红细胞聚集指数及血清VEGF水平等指标上的变化。结果治疗总有效率:观察组为78.26%,对照组为54.34%,观察组高于对照组,差异有统计学意义(P<0.05);创面愈合率:观察组为76.63%±7.43%,对照组为43.20%±6.18%,观察组高于对照组,差异有统计学意义(P<0.01);血浆纤维蛋白原、血液粘稠度及红细胞聚集指数等指标,观察组明显低于对照组,差异有统计学意义(P<0.01);血清VEGF水平两组较治疗前均显著上升,观察组治疗后,VEGF水平(97.45±6.90)mg/L明显高于对照组(75.70±6.17)mg/L,差异有统计学意义(P<0.01)。结论高压氧联合巴曲酶治疗WagnerⅢ级糖尿病足,降低了血浆纤维蛋白原、血液粘稠度、红细胞聚集指数,提高了血清VEGF水平,下肢微循环得以改善,明显提高了治疗有效率,是治疗WagnerlⅢl级糖尿病足的有效方法。

Objective To investigate the therapeutic effect of hyperbaric oxygen combined with batroxobin on Wagner Ⅲ diabetic foot patients.Methods Ninety-two cases of grade Wagner Ⅲ diabetic foot patients were analyzed retrospectively from September 2018 to January 2020 in reparative and reconstructive surgery of the second affiliated Hospital of Dalian Medical University.It was divided into control group(46 cases)and observation group(46 cases).The control group was treated with routine dressing change on the basis of controlling blood sugar,and the observation group was treated with hyperbaric oxygen and batroxobin on the basis of the control group.Wound healing rate,plasma fibrinogen,blood viscosity,erythrocyte aggregation index and serum VEGF level were compared between two groups.Results The total fective rate(78.26%)in the observation group was significantly higher than that in the control group(54.34%),the difference was statistically significant(P<0.05),the wound healing rate in the observation group43.20%±6.18%was significantly higher than that in the control group 43.20%±6.18%(P<0.01),and the plasma fibrinogen,blood viscosity and erythrocyte aggregation index in the observation group were significantly lower than those in the control group(P<0.01);The serum VEGF level in the observation group and the control group was significantly higher than that before treatment,and the mg/L of(97.45±6.90)in the observation group was significantly higher than that in the control group(75.70±6.17)mg/L,the difference was statistically significant(P<0.01).Conclusion Hyperbaric oxygen combined with batroxobin can reduce plasma fibrinogen,blood viscosity can reduce plasma fibrinogen,blood viscosity,erythrocyte aggregation index,improve serum VEGF level,improve microcirculation of lower extremity,improve the total effective rate of treatment,promote wound healing,and be an effective method for the treatment of WagnerⅢgrade diabetic foot.