Clinical Study of Vacuum Sealing Drainage Combined with Growth Factor in Treatment of Diabetic Foot Ulcer
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摘要:
目的 探讨创面封闭式负压引流（VSD）联合人表皮生长因子治疗糖尿病足溃疡的临床效果。 方法 选取2022年1月至2024年1月于哈尔滨二四二医院普外一科和血管外科收治的糖尿病足溃疡住院患者62例（wagner分级2～4级）为研究对象，均接受规范的控制血压、调节血糖血脂、抗感染等全身性基础治疗及溃疡创面彻底清创的条件下，应用随机数字表法将患者分为对照组（n = 30）和实验组（n = 32）。对照组采用溃疡创面湿敷换药的常规治疗方案，实验组采用VSD联合生长因子进行治疗。治疗6周后，比较2组患者足溃疡创面治疗有效率、创面面积、抗生素使用时间、创面愈合时间以及不良反应。 结果 实验组较对照组创面治疗有效率高（χ2 = 4.26，P = 0.031），差异有统计学意义（P < 0.05）；实验组治疗后创面面积小于对照组，差异有统计学意义（P < 0.05）；实验组抗生素使用时间（t = 6.145，P < 0.001）、创面愈合时间（t = 9.486，P < 0.001）均小于对照组，差异有统计学意义（P < 0.05）；2组患者在整个治疗周期均未出现明显的不良反应。 结论 VSD联合生长因子治疗DFUs效果显著，可以提高DFUs创面治疗有效率、降低抗生素使用时间、缩短创面愈合时间且安全可靠。 Abstract:Objective To investigate the clinical effect of vacuum sealing drainage （VSD） combined with human epidermal growth factor in the treatment of diabetic foot ulcers. Methods A total of 62 patients diagnosed with diabetic foot ulcer （wagner grade 2～4） hospitalized in the first department of General Surgery and Vascular Surgery of Harbin 242 Hospital from January 2022 to January 2024 were selected as the study subjects. All patients were given standard systemic basic treatments such as controlling blood pressure, blood sugar, blood lipids, anti-infection, and thorough debridement of ulcer wounds. The patients were randomly divided into control group （n = 30） and experimental group （n = 32） by using random number table. The control group received a routine treatment plan of hydropathic compress and dressing change for ulcer wounds, while the experimental group accepted VSD combined with growth factors. Compared with the effective rate, wound area, duration of antibiotic use , wound healing time, and adverse reactions of foot ulcer wounds between two groups of patients after 6 weeks of treatment. Results The effective rate （χ2 = 4.26, P = 0.031） in the experimental group were significantly higher than that in the control group. The wound area in the experimental group was smaller than that in the control group after treatment（P < 0.05）, the duration of antibiotic use （t = 6.145, P < 0.001） and wound healing time （t = 9.486, P < 0.001） in the experimental group were significantly lower than these in control group. There were no obvious adverse reactions in two groups. Conclusion VSD combined with growth factor has a significant effect in the treatment of DFUs, which can enhance the treatment efficiency, reduce the duration of antibiotic use, shorten the wound healing time, safely and reliable as well. -
Key words:
- Diabetic foot /
- Vacuum sealing drainage /
- Growth factor
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表 1 2组患者的一般资料比较[（$\bar x \pm s $）/n（%）]
Table 1. Comparison of general data between the two groups[（$\bar x \pm s $）/n（%）]
组别 性别 年龄（岁） 体重指数/（kg/m2） HbA1c（%） Wagner分级 男 女 2 3 4 对照组 16（53.3） 14（46.7） 60.45±8.56 22.51±3.01 8.56±2.04 13（43.3） 10（33.3） 7（23.4） 实验组 15（46.9） 17（53.1） 62.16±9.38 21.85±2.15 8.19±1.78 13（40.6） 11（34.4） 8（25.0） χ2/t 0.987 1.561 1.674 0.536 0.168 P 0.399 0.364 0.192 0.682 0.931 
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表 2 2组患者创面治疗有效率比较[n（%）]
Table 2. Comparison of wound treatment effectiveness between the two groups [n（%）]
组别 n 治愈 显效 有效 无效 有效率 对照组 30 20（66.67） 1（3.33） 2（6.66） 7（23.33） 23（76.77） 实验组 32 28（87.50） 1（3.13） 1（3.13） 2（6.25） 30（93.75） χ2 4.26 P 0.031* *P < 0.05。
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表 3 2组患者创面面积比较[（$\bar x \pm s $），cm2]
Table 3. Comparison of wound area between the two groups [（$\bar x \pm s $），cm2]
组别 治疗前创面面积 治疗后创面面积 对照组 9.23±1.98 2.81±0.69 实验组 9.87±1.67 1.65±0.38 t 0.633 11.843 P 0.617 0.029* *P < 0.05。
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表 4 2组患者抗生素使用时间、创面愈合时间比较（$\bar x \pm s $）
Table 4. Comparison of antibiotic use time and wound healing time between the two groups （$\bar x \pm s $）
组别 抗生素使用时间（d） 创面愈合时间窗（d） 对照组 11.4±2.3 40±2.6 实验组 9.1±1.7 33.5±3.1 t 6.145 9.486 P <0.001* <0.001* *P < 0.05。
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