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背景:糖尿病患者全身营养状况不良和免疫功能低下导致其皮肤慢性溃疡愈合困难,常规创面治疗方法效果不佳。目的:探讨负压创伤治疗技术在糖尿病皮肤慢性溃疡治疗中的安全性和有效性。方法:纳入 2007 年 7 月至 2010 年 12 月在广西壮族自治区人民医院内分泌科治疗的糖尿病皮肤慢性溃疡患者 144 例,其中糖尿病足溃疡 132 例,压疮 12 例。分别采用负压创伤治疗技术或传统清创、换药方法治疗;同时均辅以控制血糖及血压、抗凝、抗感染及对症支持治疗。结果与结论:采用负压创伤治疗技术治疗的 109 例患者溃疡愈合 60 例,显效 30例,有效 14 例,无效 5 例,总有效率95.4%。采用传统清创、换药方法治疗的35 例患者溃疡愈合 17 例,显效 10 例,有效 3 例,无效 5 例,总有效率 85.7%。两组总有效率比较差异有显著性意义(P <0.05)。且负压创伤治疗可明显提高糖尿病足溃疡患者溃疡周边组织氧分压,负压泵连续运行最长 120 d,无并发症出现。说明负压创伤治疗技术在糖尿病皮肤慢性溃疡治疗中具有良好的安全性和有效性。
Background: The general malnutrition and immune dysfunction of diabetic patients lead to the healing of chronic ulcer of the skin. The treatment of conventional wounds is ineffective. Objective: To investigate the safety and effectiveness of negative pressure wound therapy in the treatment of diabetic chronic skin ulcers. Methods: A total of 144 patients with diabetic chronic ulcer were included in the Department of Endocrinology, People ’s Hospital of Guangxi Zhuang Autonomous Region from July 2007 to December 2010. There were 132 diabetic foot ulcers and 12 pressure ulcers. Were treated with negative pressure trauma or traditional debridement, dressing method of treatment; supplemented by the control of blood glucose and blood pressure, anticoagulant, anti-infective and symptomatic and supportive treatment. RESULTS AND CONCLUSION: In the 109 cases treated with negative pressure wound therapy, 60 cases of ulcer healed, 30 cases were markedly effective, 14 cases were effective, 5 cases were ineffective and the total effective rate was 95.4%. Thirty-five patients with conventional debridement and dressing-changing method healed in 17 cases, 10 cases markedly effective, 3 effective and 5 ineffective, with a total effective rate of 85.7%. The total effective rate was significantly different between the two groups (P <0.05). Negative pressure wound treatment can significantly improve the partial pressure of oxygen in peripheral tissues of patients with diabetic foot ulcer, and the negative pressure pump can run continuously for up to 120 days without complication. Description of negative pressure wound treatment of diabetic skin chronic ulcer treatment has good safety and effectiveness.