华西医学

华西医学

自体富血小板凝胶治疗难愈性糖尿病足溃疡的效果研究

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目的 探讨自体富血小板凝胶(autologous platelet-rich gel,APG)联合智能创伤负压综合治疗仪治疗难愈性糖尿病足溃疡的效果。 方法 将 2015 年 1 月—2017 年 1 月医院收治的难愈性糖尿病足溃疡患者 80 例采用随机数字表法分为对照组和试验组,每组各 40 例。两组均给予常规治疗,在此基础上,对照组给予智能创伤负压综合治疗仪治疗,试验组给予 APG 联合智能创伤负压综合治疗仪交替治疗,临床观察 12 周。记录两组治愈率及痊愈时间,记录治疗前及治疗 2、4、8、12 周后两组创面体积变化。 结果 试验组治疗总有效率(87.5%)高于对照组(67.5%),差异有统计学意义(P<0.05)。两组治疗 4、8、12 周创面体积较治疗前和治疗 2 周缩小,差异有统计学意义(P<0.05);试验组治疗后创面 4、8、12 周创面体积明显少于对照组,差异有统计学意义(P<0.05)。试验组 Wagner Ⅱ级和Ⅲ级患者愈合时间[(24.71±4.29)、(33.04±5.97)d]均明显短于对照组[(33.84±6.09)、(45.29±7.05)d],差异有统计学意义(P<0.05)。 结论 APG 联合智能创伤负压综合治疗仪交替治疗难愈性糖尿病足溃疡可促使创面愈合,缩短创面愈合时间,提高临床疗效。

Objective To investigate the effects of autologous platelet-rich gel (APG) combined with intelligent trauma negative-pressure comprehensive therapeutic instrument on patients with refractory diabetic foot ulcer (DFU). Methods A total of 80 patients with refractory DFU treated in the hospital from January 2015 to January 2017 were divided into the trial group (n=40) and the control group (n=40) by the random number table method. The patients in the two groups were given routine treatment, and on the basis, the patients in the control group were treated with the intelligent trauma negative-pressure comprehensive therapeutic instrument while the ones in the trial group were treated with APG combined with intelligent trauma negative-pressure therapeutic instrument alternately. All patients were observed for 12 weeks. The cure rates, healing time and changes of wound volumes in the two groups before treatment and at 2, 4, 8, and 12 weeks after treatment were recorded. Results The total effective rate of treatment in the trial group was higher than that in the control group (87.5% vs. 67.5%, P<0.05). The wound volumes in the two groups at 4, 8 and 12 weeks after treatment were smaller than those before treatment and at 2 weeks after treatment (P<0.05). The wound volumes in the trial group at 4, 8 and 12 weeks after treatment were significantly smaller than those in the control group (P<0.05). The healing times of Wagner Ⅱ and Ⅲ DFU in the trial group were significantly shorter than those in the control group [(24.71±4.29)vs. (33.84±6.09) days, P<0.05; (33.04±5.97)vs. (45.29±7.05) days, P<0.05]. Conclusion Alternate treatment with APG combined with intelligent trauma negative-pressure comprehensive therapeutic instrument for refractory DFU can promote wound healing, shorten wound healing time, and improve the clinical efficacy.

关键词: 糖尿病足溃疡; 难愈性; 自体富血小板凝胶; 负压引流; 智能; 愈合时间

Key words: Diabetic foot ulcer; Refractory; Autologous platelet-rich gel; Negative-pressure drainage; Intelligence; Healing time

引用本文: 郭建, 杨芳, 温雅, 许璇, 唐勤. 自体富血小板凝胶治疗难愈性糖尿病足溃疡的效果研究. 华西医学, 2018, 33(11): 1411-1414. doi: 10.7507/1002-0179.201810020 复制

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