外科清创及游离植皮结合封闭负压疗法治疗糖尿病足溃疡疗效探讨

王军良 于曰英

[摘要] 目的 患有糖尿病患者出現足溃疡后实施外科清创和游离植皮与封闭负压法相结合的治疗方式，分析观察其治疗效果。 方法 该文的研究样本均选取于2016年9月—2018年8月在该院接受糖尿病治疗且出现足溃疡的患者，共计124例，根据入院时间将样本随机分为结合组和惯例组，惯例组实施常规临床治疗，结合组实施外科清创和游离植皮与封闭负压法相结合的治疗方式，经不同方法治疗前后患者的临床指标变化及治疗效果进行对比。 结果 治疗前结合组患者的空腹血糖值与惯例组患者的空腹血糖值相近，差异无统计学意义（P>0.05）;经治疗后结合组患者的空腹血糖值明显低于惯例组患者的空腹血糖值（P<0.05）;治疗前结合组的足背动脉的血流速度与惯例组的数值相近，差异无统计学意义（P>0.05）;治疗后，结合组的足背动脉的血流速度比惯例组的足背动脉的血流速度更快（P<0.05），数据结果经对比可知结合组患者足背动脉的血流速度更快（P<0.05）;结合组患者的治疗总有效率为93.54%，惯例组患者的治疗总有效率为87.09%，相比之下，结合组患者的治疗效果更加显著（P<0.05）。 结论 将外科清创和游离植皮结合封闭负压法应用于糖尿病足溃疡患者的临床治疗中，可以有效促进患者的足部血液循环，改善患者的血糖指标，提升患者的临床疗效，降低患者的痛苦，具有在临床中应用的价值。

[关键词] 糖尿病;足溃疡;外科清创

[中图分类号] R4          [文献标识码] A          [文章编号] 1672-4062（2020）05（b）-0178-03

Effect of Surgical Debridement and Free Skin Grafting Combined with Closed Negative Pressure Therapy on Diabetic Foot Ulcers

WANG Jun-liang， YU Yue-ying

Juxian People's Hospital， Rizhao， Shandong Province， 276500 China

[Abstract] Objective To perform a surgical debridement and free skin grafting combined with closed negative pressure after the treatment of foot ulcers in patients with diabetes， and analyze and observe the therapeutic effect. Methods The study samples in this article were selected from September 2016 to August 2018 in the hospital for diabetic patients with foot ulcers， a total of 124 cases. The samples were randomly divided into a combination group and a conventional group according to the time of admission. The conventional group performed routine clinical treatment， The combined group with surgical debridement and free skin grafting combined with closed negative pressure treatment. The patients' clinical indicators and treatment effects were compared before and after treatment with different methods. Results The fasting blood glucose of patients in the combination group before treatment was similar to that of patients in the conventional group， and the data were not statistically significant （P>0.05）. After treatment， the fasting blood glucose of patients in the combination group was significantly lower than that of patients in the conventional group（P<0.05）; The blood flow velocity of the dorsal foot artery in the combination group before treatment was similar to that in the conventional group， and the data was not statistically significant （P>0.05）; after treatment， the blood flow of the dorsal foot artery in the combination group was faster than that of the dorsal foot artery in the conventional group （P<0.05）. The comparison of the data shows that the blood velocity of the dorsal foot artery in the combination group is faster（P<0.05）; the efficiency was 93.54%， and the total effective rate of patients in the conventional group was 87.09%. In contrast， the treatment effect of the patients in the combination group was more significant （P<0.05）. Conclusion The application of surgical debridement and free skin grafting in combination with closed negative pressure in the clinical treatment of patients with diabetic foot ulcers can effectively promote the blood circulation of patients' feet， improve the patient's blood glucose index， improve the clinical efficacy of patients， and reduce pain， which has value in clinical application.

[Key words] Diabetes; Foot ulcer; Surgical debridement

足部作为糖尿病患者在临床中较为常见的靶器官之一，绝大多数的患者出现该症状是由于周围神经病变或外周血管疾病导致血管压力过高，最终造成患者的足部软组织、骨关节出现受损畸形的情况，患者的足部会出现一定程度的症状，轻者神经症状，严重者会出现感染、血管疾病及溃疡的现象，患者在出现该类症状时，需要及时进行治疗，否则一旦错失最佳治疗时机，会使患者的生命安全受到严重的威胁[1]。在该类病症的临床中传统的治疗方式是由清创、引流和换药等几种基础操作共同组成的治疗模式，随着我国医疗技术的不断提高，对于该类病症的治疗方式也出现了一定的创新[2]。该研……