中华损伤与修复杂志（电子版）
中華損傷與脩複雜誌（電子版）
중화손상여수복잡지（전자판）
Chinese Journal of Injury Repair and Wound Healing
2012年
2期
23-25,29
,共4页
张明玮%谢京波%史煜华%姜玉峰%陈阿鑫%许樟荣%刘志国
張明瑋%謝京波%史煜華%薑玉峰%陳阿鑫%許樟榮%劉誌國
장명위%사경파%사욱화%강옥봉%진아흠%허장영%류지국
负压伤口疗法%糖尿病足%截肢术%修复外科手术
負壓傷口療法%糖尿病足%截肢術%脩複外科手術
부압상구요법%당뇨병족%절지술%수복외과수술
Negative-pressure wound therapy%Diabetic foot%Amputation%Reconstructive surgical procedures
目的 改善糖尿病足修复手术治疗效果,减少大截肢,缩短治疗时间.尽可能保留糖尿病足患者足部功能,提高生活质量.方法 将2006年1月至2008年10月解放军306医院治疗的82例糖尿病足坏疽患者(Wagner4,5级)设为单纯手术组.该组患者进行清创修复或小截肢手术,术后给予常规换药14d后拆线.将2008年11月至2011年6月解放军306医院治疗的91例糖尿病足坏疽患者(Wagner4,5级)设为联合负压组,该组患者手术联合封闭负压冲洗引流.持续负压引流6～7d,拆除负压引流后换药7d后拆线.比较两组患者保足率(修复或小截肢手术成功率)和治疗时间.结果 单纯手术组57例术后伤口愈合,25例术后伤口愈合不良,再次行截肢手术治疗,保足率为69.5％,平均治疗时间为43.1d.联合负压组80例伤口愈合,11例愈合不良二次手术,保足率为87.9％,平均治疗时间为33.7d.联合负压组保足率高于单纯手术组且平均治疗时间低于单纯手术组(P＜0.05).结论 封闭负压引流技术可以提高严重糖尿病足修复或小截肢修复治疗的成功率,促进术后伤口愈合,防止感染并缩短治疗时间.
目的 改善糖尿病足脩複手術治療效果,減少大截肢,縮短治療時間.儘可能保留糖尿病足患者足部功能,提高生活質量.方法 將2006年1月至2008年10月解放軍306醫院治療的82例糖尿病足壞疽患者(Wagner4,5級)設為單純手術組.該組患者進行清創脩複或小截肢手術,術後給予常規換藥14d後拆線.將2008年11月至2011年6月解放軍306醫院治療的91例糖尿病足壞疽患者(Wagner4,5級)設為聯閤負壓組,該組患者手術聯閤封閉負壓遲洗引流.持續負壓引流6～7d,拆除負壓引流後換藥7d後拆線.比較兩組患者保足率(脩複或小截肢手術成功率)和治療時間.結果 單純手術組57例術後傷口愈閤,25例術後傷口愈閤不良,再次行截肢手術治療,保足率為69.5％,平均治療時間為43.1d.聯閤負壓組80例傷口愈閤,11例愈閤不良二次手術,保足率為87.9％,平均治療時間為33.7d.聯閤負壓組保足率高于單純手術組且平均治療時間低于單純手術組(P＜0.05).結論 封閉負壓引流技術可以提高嚴重糖尿病足脩複或小截肢脩複治療的成功率,促進術後傷口愈閤,防止感染併縮短治療時間.
목적 개선당뇨병족수복수술치료효과,감소대절지,축단치료시간.진가능보류당뇨병족환자족부공능,제고생활질량.방법 장2006년1월지2008년10월해방군306의원치료적82례당뇨병족배저환자(Wagner4,5급)설위단순수술조.해조환자진행청창수복혹소절지수술,술후급여상규환약14d후탁선.장2008년11월지2011년6월해방군306의원치료적91례당뇨병족배저환자(Wagner4,5급)설위연합부압조,해조환자수술연합봉폐부압충세인류.지속부압인류6～7d,탁제부압인류후환약7d후탁선.비교량조환자보족솔(수복혹소절지수술성공솔)화치료시간.결과 단순수술조57례술후상구유합,25례술후상구유합불량,재차행절지수술치료,보족솔위69.5％,평균치료시간위43.1d.연합부압조80례상구유합,11례유합불량이차수술,보족솔위87.9％,평균치료시간위33.7d.연합부압조보족솔고우단순수술조차평균치료시간저우단순수술조(P＜0.05).결론 봉폐부압인류기술가이제고엄중당뇨병족수복혹소절지수복치료적성공솔,촉진술후상구유합,방지감염병축단치료시간.
Objective To improve the effects of wound repair in diabetic foot treatment,reduce tissue damage and decrease the time for treatment,and to keep patients' ability to stand and walk.Methods From January 2006 to October 2008,82 cases of diabetic foot gangrene ( Wagner 4,5 ) treated with plastic surgery or minor amputation were set to the group of surgery only.From November 2008 to June 2011,91cases of diabetic foot gangrene (Wagner 4,5) treated with negative pressure wound therapy served as the group of co-negative.Continuous negative pressure drainage was used about 6 to 7 days after operation,and then sutures were taken out 7 days after removing the negative pressure dressing.The rate of limbs preserving and time for treatment in two groups were compared.Results In the group of surgery only,57 cases got wound healing,and 25 cases got delayed wound healing.The average time of hospitalization was 43.1 days.The rate of limbs preserving was 69.5％.In the group of co-negative,80 cases got wound healing,and 11patients got delayed wound healing.The average time of hospitalization was 33.7 days.The rate of limbs preserving was 87.9％.The limbs preserving rate of co-negative group was higher than that of the surgery only group and the average treatment time of co-negative group was less than that of the surgery only group ( P ＜ 0.05 ).Conclusion Negative pressure wound therapy can improve the success rate of wound repair in diabetic foot,promote wound healing and reduce tissue damage,and decrease the time for treatment.
