| 车建芳,覃艳,季明晶.水刀清创术联合真空辅助闭合技术治疗糖尿病足溃疡疗效及对足背动脉血流、血小板衍生生长因子受体水平的影响[J].安徽医药,2025,29(11):2190-2194. |
| 水刀清创术联合真空辅助闭合技术治疗糖尿病足溃疡疗效及对足背动脉血流、血小板衍生生长因子受体水平的影响 |
| Effect of waterjet debridement combined with vacuum assisted closure in the treatment of patients with diabetic foot ulcer and the impact on blood flow of dorsalis pedis artery and platelet-derived growth factor receptor levels |
| |
| DOI：10.3969/j.issn.1009-6469.2025.11.014 |
| 中文关键词: 糖尿病足 水刀清创术 真空辅助闭合技术 创口愈合 血小板衍生生长因子受体 |
| 英文关键词: Diabetic foot Waterjet debridement Vacuum-assisted closure Wound healing Platelet-derived growth factor re-ceptor |
| 基金项目:河南省医学科技攻关计划(联合共建)项目( LHGJ20190461) |
|
| 摘要点击次数: 471 |
| 全文下载次数: 174 |
| 中文摘要: |
| 目的探讨水刀清创术联合真空辅助闭合技术( VAC)治疗糖尿病足溃疡( DFU)疗效及对创面肉芽组织生长情况、血小板衍生生长因子受体( PDGFR)-α、PDGFR-β及足背动脉血流的影响。方法选取 2022年 1月至 2023年 6月中国人民解放军东部战区空军医院收治的 98例 DFU病人为研究对象，采用随机数字表法分为两组，对照组 47例给予水刀清创后行创面游离皮片移植修复，研究组 51例采用水刀清创术联合 VAC治疗，比较两种治疗方式疗效，并对比创面肉芽组织生长情况、 PDGFR-α、 PDGFR-β水平及足背动脉血流等指标。结果研究组治疗总有效率 94.12%(48/51)高于对照组 76.60%(36/47)(P<0.05)；究组肉芽组织生长厚度为(5.61±0.62)cm、肉芽组织覆盖率为( 78.33±8.15)%、创面缩小率为( 81.26±8.71)%均显著高于对照组研(4.26±0.45)cm、(69.54±7.16)%、(72.36±7.23)%，创面愈合时间为( 25.26±3.21)d短于对照组( 43.21±4.52)d(均 P<0.05)；治疗后两组 PDGFR-α、PDGFR-β、血管内皮生长因子( VEGF)、碱性成纤维细胞生长因子(bFGF)、转化生长因子 β1(TGF-β1)均显著升高，且研究组以上指标均明显高于对照组( P<0.05)；治疗后两组最快流速、最慢流速显著升高，阻力系数降低，研究组最快流速、最慢流速均明显高于对照组，阻力系数低于对照组( P<0.05)。结论水刀清创术联合 VAC治疗 DFU疗效显著，可有效促进创面肉芽组织生长及创面愈合，其作用机制可能与改善创面组织血液循环及生长因子水平，提高 PDGFR水平有关。 |
| 英文摘要: |
| Objective To investigate the effect of waterjet debridement combined with vacuum assisted closure (VAC) in the treat-ment of diabetic foot ulcer (DFU), and the impact on wound granulation tissue growth, platelet-derived growth factor receptor (PDGFR)-α and PDGFR-β levels, and blood flow of dorsalis pedis artery.Methods A total of 98 patients with DFU admitted to Air Force Hospitalof PLA Eastern Theater Command from January 2022 to June 2023 were selected as the research objects. They were divided into twogroups by random number table method. Forty-seven patients in the control group were treated with free skin grafting after waterjet de-bridement, and 51 patients in the study group were treated with waterjet debridement combined with VAC. Therapeutic effects, woundgranulation tissue growth, PDGFR-α and PDGFR-β levels, and blood flow of dorsalis pedis artery were compared between the two groups.Results The total effective rate of treatment in the study group was 94.12% (48/51), which was higher than that in the controlgroup [76.60% (36/47)] (P<0.05). The thickness of granulation tissue, coverage rate of granulation tissue and wound reduction rate inthe study group were (5.61±0.62) cm, (78.33±8.15) % and (81.26±8.71) %, which were significantly greater/higher than those in thecontrol group [(4.26±0.45) cm, (69.54±7.16) % and (72.36±7.23) %]. The wound healing time was (25.26±3.21) d, which was shorterthan that in the control group [(43.21±4.52) d] (all P<0.05). After treatment, the levels of PDGFR-α, PDGFR-β, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and transforming growth factor β1 (TGF-β1) in both groups increased sig-nificantly, and the levels in the study group were significantly higher than those in the control group (P<0.05). After treatment, the fast-est and slowest flow rates in the two groups increased significantly, and the resistance coefficient decreased. The fastest and slowestflow rates in the study group were significantly higher than those in the control group, and the resistance coefficient was lower than thatin the control group (P<0.05).Conclusions Waterjet debridement combined with VAC is effective to treat DFU, which can effectivelypromote wound granulation tissue growth and wound healing. The mechanism of action may be improvement of blood circulation inwound tissue and growth factor levels, and the increase in PDGFR level. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
