摘要
目的分析糖尿病足致感染性创面治疗中应用Masquelet技术的效果。方法68例糖尿病足致感染性创面患者,随机将其分为对照组和观察组,每组34例。对照组采用负压封闭引流技术(VSD)治疗,观察组采用Masquelet技术治疗。比较两组创面愈合情况、不良事件发生情况、炎性指标、血管生长因子、足部微循环血流灌注指标。结果干预后,观察组的创面肉芽形态评分(1.04±0.42)分、创面面积(6.46±2.03)cm~2、视觉模拟评分法(VAS)评分(4.18±1.03)分均低于对照组的(1.72±0.58)分、(8.57±2.52)cm~2、(4.97±1.25)分,创面愈合所需时长(24.48±5.25)d短于对照组的(29.74±5.84)d,差异显著(P<0.05);干预后,两组的降钙素原(PCT)、C反应蛋白(CRP)、红细胞沉降率(ESR)水平均出现了不同程度的降低,而血管内皮生长因子(VEGF)、血小板源性生长因子(PDGF)水平有一定的增高,且与对照组比较,观察组改善幅度更明显,差异显著(P<0.05);干预后,两组足背动脉血流速度、足背动脉血管内径、足趾温度、踝肱指数(ABI)均较干预前明显改善,且观察组足背动脉血流速度(37.04±5.87)cm/s、足背动脉血管内径(2.25±0.67)mm均大于对照组的(32.69±5.74)cm/s、(1.83±0.57)mm,足趾温度(35.59±1.27)℃、ABI(0.81±0.16)均高于对照组的(31.74±1.15)℃、(0.70±0.12),差异显著(P<0.05);与对照组的32.35%、17.65%比较,观察组的溃疡复发率8.82%、截肢率0均更低,差异显著(P<0.05)。结论在糖尿病足致感染性创面治疗中应用Masquelet技术效果显著,可以有效促进创面愈合,减轻炎症反应,提高血管生长因子水平,取得更好的足部微循环血流灌注改善效果,并且能够有效减少溃疡的复发,提高保肢率,具有较高的临床推广应用价值。
Objective To analyze the effect of the Masquelet technique in infectious wounds caused by diabetic foot.Methods 68 patients with infectious wounds of diabetic foot were randomly divided into control group and observation group,with 34 cases in each group.The control group was treated with vacuum sealing drainage(VSD),and the observation group was treated with Masquelet technique.The wound healing,occurrence of adverse events,inflammatory index,vascular growth factor and microcirculation perfusion index of the foot were compared between the two groups.Results After intervention,the wound granulation morphology score in the observation group was(1.04±0.42)points,the wound area was(6.46±2.03)cm2 and the visual analogue scale(VAS)score was(4.18±1.03)points,which were lower than(1.72±0.58)points,(8.57±2.52)cm2 and(4.97±1.25)points in the control group;the wound healing time of(24.48±5.25)d in the observation group was shorter than(29.74±5.84)d in the control group;the difference was significant(P<0.05).After intervention,the levels of procalcitonin(PCT),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in both groups were decreased to varying degrees,while the levels of vascular endothelial growth factor(VEGF)and platelet-derived growth factor(PDGF)were increased to some extent;compared with the control group,the improvement of the observation group was more obvious(P<0.05).After intervention,the blood flow velocity and internal diameter of dorsalis pedis artery,toe temperature and ankle-brachial index(ABI)were significantly improved in both groups compared with before intervention;the blood flow velocity and internal diameter of dorsalis pedis artery were(37.04±5.87)cm/s and(2.25±0.67)mm in the observation group,which were higher than(32.69±5.74)cm/s and(1.83±0.57)mm in the control group;the toe temperature and ABI were(35.59±1.27)℃and(0.81±0.16)in the observation group,which were higher than(31.74±1.15)℃and(0.70±0.12)in the control group;the difference was significant(P<0.05).Compared with 32.35%and 17.65%in the control group,the ulcer recurrence rate of 8.82%and amputation rate of 0 in the observation group were lower,and the differences were significant(P<0.05).Conclusion The application of Masquelet technique in the treatment of infectious wounds caused by diabetic foot has significant effects,which can effectively promote wound healing,reduce inflammation,improve the level of vascular growth factor,achieve better effect of microcirculation perfusion in the foot,effectively reduce the recurrence of ulcers,and improve the rate of limb preservation.It has a higher clinical value of popularization and application.
作者
王有福
WANG You-fu(Liyang Hospital of Traditional Chinese Medicine,Liyang 213300,China)
出处
《中国现代药物应用》
2025年第11期60-63,共4页
Chinese Journal of Modern Drug Application
