糖尿病性皮肤溃疡创面的修复

The reconstruction of diabetic skin ulcer

目的 探讨促进糖尿病性皮肤溃疡创面愈合、缩短病程和降低致残率的好方法。方法 对 6 8例糖尿病性皮肤溃疡患者采用控制血糖、增加营养、防治感染等措施 ,以稳定病情为基础 ,以创面局部清创、改善局部血运和外用药物换药培育肉芽生长为条件 ,以整形手术为手段的方法治疗。结果 病情平稳 ,所有创面均顺利修复 ,创面愈合时间平均 2 8天 ,无截肢现象。平均随访时间 1年 ,随访率 86 .7% ,疗效满意率 81.4 % ,出现溃疡复发或新的皮肤溃疡者占 18.6 %。结论 多科室合作在全身治疗稳定病情的基础上 ,积极行创面局部处理和手术治疗是促进糖尿病性皮肤溃疡创面早期修复、缩短病程和降低致残率切实可行的方法 。

Objective To study a good method of promoting healing of diabetic skin ulcer, shortening the course and reducing the rate of disability. Methods 68 diabetic skin ulcer patients were treated under multiple departments worked cooperatively by the following measures: controlling blood sugar、 enhancing nutrition、 preventing or treating infection to stabilize the state of illness, debriding wounds、 improving local blood circulation、 wound dressing with proper drugs and proper plastic surgery to deal with skin ulcer. Results Illness condition of all cases was stable. All skin ulcers were cured and healed successfully. The average date of wound healing was 28 days without any single case of amputation. 86.7 percent of cases were followed up averaged 1 year, the satisfactory rate was 81.4 percent, ulcer recurring rate (including in elsewhere) was 18.6 percent. Conclusion Systemic measurements of stabilizing illness condition combined with active treatment of wounds was a practical and effective method of promoting the healing of diabetic skin ulcer, shortening its course and reducing the rate of disability. It also showed patients education after discharge from the hospital was very important.