前列地尔联合封闭负压引流术治疗2型糖尿病足溃疡的效果

Effect of Alprostadil Combined with Closed Negative Pressure Drainage Surgery in the Treatment of Type 2 Diabetic Foot Ulcer

目的:探究前列地尔联合封闭负压引流术治疗2型糖尿病足溃疡的效果。方法:选取2021年7月—2023年7月济南市天桥人民医院收治的132例2型糖尿病足溃疡患者。根据摸球法将其分为对照组(n=66,奇数)和观察组(n=66,偶数)。对照组给予封闭负压引流术治疗,观察组给予前列地尔联合封闭负压引流术治疗。比较两组治疗前及治疗1个月后溃疡愈合情况、氧化应激指标、生长因子、神经传导速度。结果:治疗1个月后,观察组创面深度、腐肉覆盖、红肿范围、分泌物评分均低于对照组,差异有统计学意义(P<0.05)。治疗1个月后,观察组丙二醛(MDA)、晚期氧化蛋白产物(AOPP)水平均低于对照组,超氧化物歧化酶(SOD)水平高于对照组,差异有统计学意义(P<0.05)。治疗1个月后,观察组血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平均高于对照组,色素上皮衍生因子(PEDF)水平低于对照组,差异有统计学意义(P<0.05)。治疗1个月后,观察组腓总神经感觉传导速度、运动传导速度,正中神经感觉传导速度、运动传导速度均高于对照组,差异有统计学意义(P<0.05)。结论:前列地尔联合封闭负压引流术能有效促进2型糖尿病足溃疡患者溃疡愈合,调节其氧化应激水平及血管生成因子,并提高神经传导速度。

Objective:To explore the effect of Alprostadil combined with closed negative pressure drainage surgery in the treatment of type 2 diabetic foot ulcer.Method:A total of 132 patients with type 2 diabetic foot ulcer treated in Yaoshan Community Health Service Center,Tianqiao People's Hospital,Jinan City from July 2021 to July 2023 were selected.They were divided into control group(n=66,odd)and observation group(n=66,even)according to ball-touching method.The control group was treated with closed negative pressure drainage surgery,and the observation group was treated with Alprostadil combined with closed negative pressure drainage surgery.Ulcer healing condition,oxidative stress index,growth factor and nerve conduction velocity were compared between the two groups before treatment and after 1 month of treatment.Result:After 1 month of treatment,the wound depth,rotting flesh coverage,redness and swelling range,secretions and granulation situation scores in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 1 month of treatment,the levels of malondialdehyde(MDA)and advanced oxidized protein product(AOPP)in observation group were lower than those in control group,and the level of superoxide dismutase(SOD)was higher than that in control group,the differences were statistically significant(P<0.05).After 1 month of treatment,the levels of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)in observation group were higher than those in control group,and the levels of pigment epithelium-derived factor(PEDF)was lower than those in control group,the differences were statistically significant(P<0.05).After 1 month of treatment,the sensory conduction velocity,motor conduction velocity of common peroneal nerve and sensory conduction velocity and motor conduction velocity of median nerve in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).Conclusion:Alprostadil combined with closed negative pressure drainage can effectively promote ulcer healing in patients with type 2 diabetic foot ulcers,regulate oxidative stress levels and angiogenesis factors,and increase nerve conduction velocity.