本文選題：糖尿病足 + 清創(chuàng)術(shù)��； 參考：《廣東醫(yī)學(xué)》2016年14期

【摘要】：目的觀察真空負(fù)壓引流(VSD)技術(shù)聯(lián)合人工真皮治療糖尿病足的臨床療效。方法 24例糖尿病足患者平均分成兩組,全部患足仍有較大部分皮膚軟組織存在血運(yùn),予抗炎及控制血糖平穩(wěn)后,所有患足均行壞死組織清創(chuàng)術(shù)并形成新鮮創(chuàng)面。對(duì)照組12例:清創(chuàng)術(shù)后予傳統(tǒng)方法換藥治療,每天雙氧水、生理鹽水清洗,聚維酮碘紗布外敷包扎。觀察組12例:清創(chuàng)術(shù)后應(yīng)用VSD技術(shù)治療創(chuàng)面,創(chuàng)面感染控制、肉芽組織生長(zhǎng)后植入人工真皮,待其肉芽生長(zhǎng)滿意后行植皮術(shù)。觀察患者住院時(shí)間及愈合質(zhì)量,包括截肢率及瘢痕增生情況等。結(jié)果對(duì)照組住院時(shí)間(52.2±6.7)d,其中截肢患者5例,創(chuàng)面瘢痕愈合患者3例,最后經(jīng)植皮修復(fù)者4例。觀察組住院時(shí)間(30.5±5.9)d,其中3例創(chuàng)面較小患者經(jīng)應(yīng)用VSD技術(shù)聯(lián)合人工真皮后創(chuàng)面瘢痕愈合,瘢痕增生輕;8例創(chuàng)面較大患者應(yīng)用VSD技術(shù)聯(lián)合人工真皮后肉芽生長(zhǎng)既快又好,肉芽滿意后行植皮手術(shù),植皮全部存活,保肢成功;1例較嚴(yán)重患者最終截肢處理。結(jié)論 VSD技術(shù)聯(lián)合人工真皮治療糖尿病足效果明顯優(yōu)于傳統(tǒng)治療方法,可降低截肢率,縮短住院時(shí)間。
[Abstract]:Objective to observe the clinical effect of vacuum negative pressure drainage (VSD) combined with artificial dermis in the treatment of diabetic foot. Methods 24 patients with diabetic foot were divided into two groups. There was still a large part of skin and soft tissue blood circulation in all affected feet. After anti-inflammatory and blood glucose control, all the affected feet underwent debridement of necrotic tissue and formed fresh wound. Control group (12 cases): after debridement, traditional methods were used to change medicine, hydrogen peroxide and saline were cleaned daily, and povidone iodine gauze was bandaged externally. In the observation group, 12 cases were treated with VSD technique after debridement, wound infection was controlled, granulation tissue was implanted into artificial dermis after debridement, and skin grafting was performed after satisfactory granulation growth. The hospitalization time and healing quality were observed, including amputation rate and scar proliferation. Results in the control group, the hospital stay was 52.2 鹵6.7 days, including 5 amputations, 3 scar healing and 4 skin graft repair. In the observation group, the duration of hospitalization was 30.5 鹵5.9 days. Three patients with small wounds were treated with VSD technique combined with artificial dermis, and 8 patients with light scar hyperplasia were treated with VSD technique and artificial dermis. The granulation growth was fast and good after the application of VSD technique and artificial dermis. After the granulation was satisfied, the skin grafts survived, and one serious patient was treated with amputation. Conclusion the effect of VSD combined with artificial dermis on diabetic foot is better than that of traditional treatment, which can reduce amputation rate and shorten hospitalization time.
【作者單位】： 廣東省茂名市人民醫(yī)院手足顯微外科;
【基金】：廣東省茂名市第二批(醫(yī)療衛(wèi)生類(lèi))科技計(jì)劃項(xiàng)目(編號(hào):2015013)
【分類(lèi)號(hào)】：R587.2

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