摘要
目的评价护创液体敷料治疗糖尿病足溃疡的临床效果和安全性。方法选择2024年10月至2025年5月收治的Wagner分级Ⅱ~Ⅲ级糖尿病足溃疡患者50例,按随机数字表法分为观察组26例和对照组24例。观察组应用护创液体敷料(主要成分为壳聚糖和羧甲基纤维素钠),对照组应用银离子敷料。比较两组溃疡面积缩小率、肉芽组织生长率、炎症标志物(白细胞计数、中性粒细胞计数、C反应蛋白、红细胞沉降率、降钙素原)下降率、创面渗出液评分、细菌负荷变化及不良反应发生率。结果观察组在治疗后各时间点溃疡面积缩小率、肉芽组织生长率、创面无渗出患者占比均显著高于对照组(P<0.01)。观察组治疗7、14 d细菌定量低于对照组,细菌负荷下降值大于对照组(P<0.01)。观察组白细胞计数、中性粒细胞计数、C反应蛋白、红细胞沉降率和降钙素原下降率均明显高于对照组(P<0.01)。两组不良反应发生率[0(0/26)vs 8.3%(2/24)]比较差异无统计学意义(P>0.05)。结论护创液体敷料通过其主要成分壳聚糖和羧甲基纤维素钠的协同作用,能够显著促进糖尿病足溃疡创面愈合,有效控制感染和炎症反应,且安全性良好。
Objective To evaluate the clinical efficacy and safety of wound-care liquid dressing in the treatment of diabetic foot ulcers(DFU).Methods Fifty patients with Wagner GradeⅡ-ⅢDFU admitted between October 2024 and May 2025 were assigned to the observation group(n=26)and the control group(n=24)using a random number table method.The observation group received wound-care liquid dressing(main components:chitosan and sodium carboxymethylcellulose),while the control group received silver ion dressing.The two groups were compared in terms of reduction rate of ulcer area,growth rate of granulation tissue,decrease rate of inflammatory markers[white blood cell count(WBC),neutrophil count(NEUT),C reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT)],wound exudate score,changes in bacterial load,and incidence of adverse reactions.Results The ulcer area reduction rate,granulation tissue growth rate,and the proportion of patients with no wound exudation in the observation group were significantly higher or larger than those in the control group at all time points after treatment(P<0.01).The bacterial quantification in the observation group was lower than that in the control group at 7 and 14 d after treatment,and the decrease in bacterial load was greater in the observation group than in the control group(P<0.01).The reduction rates of WBC,NEUT,CRP,ESR,and PCT in the observation group were significantly higher than those in the control group(P<0.01).The incidence of adverse reactions was not statistically significant between the two groups[0(0/26)vs.8.3%(2/24)](P>0.05).Conclusion Through the synergistic action of their main components,chitosan and sodium carboxymethylcellulose,wound-care liquid dressing can significantly promote the healing of DFU wounds,effectively control infection and inflammatory responses,and demonstrate good safety.
作者
王刚
蒋宜彪
刘振斌
李梦虎
王博文
雷章成
陆东亚
王煜程
WANG Gang;JIANG Yibiao;LIU Zhenbin;LI Menghu;WANG Bowen;LEI Zhangcheng;LU Dongya;WANG Yucheng(Department of Sore and Peripheral Vascular Surgery,the First Affliated Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Acupuncture and Moxibustion of Traditional Chinese Medicine,Tianjin 300381,China)
出处
《临床误诊误治》
2025年第24期76-81,共6页
Clinical Misdiagnosis & Mistherapy
基金
2024年度主题案例项目(ZT-2410063008)。
关键词
糖尿病足溃疡
护创液体敷料
壳聚糖
羧甲基纤维素
渗出
细菌定量
红细胞沉降率
diabetic foot ulcers
wound-care liquid dressing
chitosan
carboxymethylcellulose
exudate
bacterial quantification
erythrocyte sedimentation rate
