摘要
【目的】探讨Ilizarov胫骨横向骨搬移联合富血小板血浆(PRP)治疗糖尿病足难愈性创面的临床疗效。【方法】选择2018年6月至2021年6月韩城市人民医院收治的80例糖尿病足难愈性创面患者为研究对象,按照随机数字表法分为观察组和对照组,每组40例。对照组使用PRP外敷创面治疗,观察组在对照组基础上联合Ilizarov胫骨横向骨搬移治疗。比较两组临床疗效、保肢率、创面愈合情况(创面缩小率、肉芽组织生长厚度、肉芽组织覆盖率、创面植皮时间、创面愈合时间)、并发症发生情况及治疗前、治疗后6个月患足皮肤温度、视觉模拟疼痛评分法(VAS)评分、踝肱指数。【结果】与对照组相比,观察组治疗总有效率、保肢率、创面缩小率、肉芽组织覆盖率较高(P<0.05),肉芽组织生长厚度较厚(P<0.05),创面植皮时间、创面愈合时间较短(P<0.05)。治疗后,两组患足皮肤温度、踝肱指数增高(P<0.05),VAS评分降低(P<0.05);治疗后,与对照组相比,观察组患足皮肤温度、踝肱指数增高(P<0.05),VAS评分降低(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。【结论】Ilizarov胫骨横向骨搬移联合PRP治疗糖尿病足难愈性创面可提高患者治疗总有效率和保肢率,缩短创面愈合时间,且安全性较高,值得临床推广应用。
【Objective】To investigate the efficacy and safety of platelet-rich plasma(PRP)combined with Ilizarov tibial transverse bone transport in the treatment of refractory diabetic foot wounds.【Methods】A total of 80 patients with refractory diabetic foot wounds admitted to Hancheng People's Hospital from June 2018 to June 2021 were selected as the research objects.Patients were divided into the observation group(40 cases)and the control group(40 cases)by random number table method.The control group was treated with PRP external application,while the observation group was treated with Ilizarov transverse tibial bone transport on the basis of PRP in the control group.The clinical efficacy and limb salvage rate were compared between the two groups.Wound healing indicators(wound reduction rate,granulation tissue growth thickness,granulation tissue coverage rate,skin grafting time,and wound healing time)were compared between the two groups.The skin temperature of the affected foot,visual analogue scale(VAS)score and ankle brachial index were compared between the two groups before treatment and 6 months after treatment.Complications were observed and recorded in the two groups.【Results】Compared to the control group,the total effective rate and limb salvage rate of the observation group were higher(P<0.05).The observation group had higher wound reduction rate,granulation tissue coverage rate,larger granulation tissue growth thickness,shorter wound skin grafting time and wound healing time,if compared with the control group(P<0.05).After treatment,the skin temperature and ankle brachial index of the affected foot increased,and the VAS score decreased in the two groups(P<0.05).Compared to the control group,after treatment,the skin temperature and ankle brachial index of the affected foot in the observation group were higher,and the VAS score was lower(P<0.05);There was no significant difference in the total incidence of complications between the two groups(P>0.05).【Conclusion】PRP combined with Ilizarov tibial transverse bone transport in the treatment of refractory diabetic foot wounds is beneficial to improve the total effective rate and limb salvage rate and shorten the wound healing time.It has high safety,which has the value of promotion.
作者
王东福
张德林
WANG Dong-fu;ZHANG De-lin(Department of Osteology,Hancheng People's Hospital,Hancheng Shaanxi 715400)
出处
《医学临床研究》
CAS
2022年第12期1810-1813,共4页
Journal of Clinical Research
作者简介
通讯作者:张德林,E-mail:Zhangdelin2010@126.com。
