微创医学

目的探讨微动力负压护创治疗糖尿病患者足部溃疡的临床疗效及价值。方法选择糖尿病足部溃疡患者92例，根据患者意愿分为对照组（n=55）与观察组（n=37）。两组患者均使用降糖药物控制血糖在正常范围，对照组患足进行普通纱布换药，观察组患足采用微动力负压护创。治疗前及治疗后1周、2周，采用VAS评分法评估患者疼痛情况；以透明方格纸画创面形状的方法测量创面面积，计算创面愈合率，比较两组愈合情况；治疗后2周根据患者的直接换药费用（元）/ 创面愈合面积（mm2）计算换药费用面积比。结果治疗后1周、2周，两组患者VAS评分均较治疗前降低，且观察组显著低于对照组（均P＜0.05）。治疗后1周、2周，观察组创面愈合率均高于对照组，两组治疗后2周创面愈合率均较治疗后1周明显提高（均P＜0.05）。观察组完全愈合时间短于对照组（P＜0.05）。两组最终愈合率及换药费用面积比差异无统计学意义（均P＞0.05）。结论微动力负压护创治疗糖尿病患者足部溃疡，能够减轻患者疼痛，提高创面愈合率，缩短创面愈合时间，且不增加治疗费用。

ObjectiveTo explore the clinical efficacy and value of oligodynamic negative pressure wound protection in treating foot ulcers in diabetic patients. MethodsNinety-two diabetic patients with foot ulcers were selected and divided into control group (n=55) and observation group (n=37) according to their wishes. Both groups used hypoglycemic drugs to control their blood glucose around the normal range. The injured foot of the control group received ordinary gauze dressing, whereas the observation group used oligodynamic negative pressure to protect the wound. VAS score was used to evaluate the pain conditions in patients before treatment and 1, 2 weeks after treatment. Transparent quadrille papers were used to draw the shapes of the wounds, so as to measure the wound areas, to calculate the wound healing rate, and to compare the healing conditions between the two groups. After 2 weeks of treatment, the area ratio of the dressing changes were calculated according to the ratio of direct dressing change (Yuan) to the wound healing area (mm2). ResultsAfter 1 and 2 weeks of treatment, the VAS scores of the two groups were lower than those before treatment, and the score in the observation group was significantly lower than that in the control group (all P＜0.05). After 1 and 2 weeks of treatment, the wound healing rate of the observation group was higher than that of the control group, and the wound healing rate of the two groups after 2 weeks of treatment was significantly higher than that after 1 week of treatment (all P＜0.05). The observation group yielded shorter time of complete healing as compared with the control group (P＜0.05). There were no statistically significant differences in the final healing rate and the area ratio of the dressing changes between the two groups (all P＞0.05). ConclusionOligodynamic negative pressure wound protection for the treatment of foot ulcers in diabetic patients can relieve pain, improve the wound healing rate, shorten wound healing time, and it dose not increase the cost of treatment.