中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
6期
635-637
,共3页
糖尿病%糖尿病足
糖尿病%糖尿病足
당뇨병%당뇨병족
Diabetes mellitus%Diabetic foot
目的 观察皮肤创面无机诱导活性敷料(德莫林)联合纳米银医用抗菌敷料治疗老年糖尿病患者足部慢性溃疡的疗效. 方法 共收治老年糖尿病足部慢性溃疡患者93例,随机将患者分成治疗组和对照组,两组患者在进行内科治疗和局部换药的基础上,治疗组外敷德莫林联合纳米银医用抗菌敷料,对照组患者创面则覆盖0.5％碘伏油纱布,比较两组患者创面愈合情况、创面愈合时间和创面菌培养阳性率. 结果 治疗组平均治疗时间(41.6±2.7)d,明显短于对照组(61.9±2.9)d(t=35.09,P=0.000);治疗组患者入院时、入院14d和28 d细菌培养阳性率分别为88.46％、23.07％和15.38％,对照组分别为88.89％、59.26％和40.74％(x2=0.01、6.88、7.34,P=0.065、0.008、0.006).对照组47例患者有效率63.83％ (30/47),显著低于治疗组82.61％(38/46)(x2=4.17,P=0.035).按瓦格纳(Wanger)系统对糖尿病足病变严重程度进行分级,治疗组27例2级病变患者有效率为88.89％(24/27),显著高于对照组67.86％(18/28)(x2 =4.60,P=0.032);3级病变治疗组19例有效率为73.86％(14/19),与对照组的63.15％(12/19)比较,差异无统计学意义(x2=0.49,P=0.364). 结论 德莫林联合纳米银医用抗菌敷料能改善2级糖尿病足部慢性溃疡的愈合,但对于3级以上病变效果不明显.
目的 觀察皮膚創麵無機誘導活性敷料(德莫林)聯閤納米銀醫用抗菌敷料治療老年糖尿病患者足部慢性潰瘍的療效. 方法 共收治老年糖尿病足部慢性潰瘍患者93例,隨機將患者分成治療組和對照組,兩組患者在進行內科治療和跼部換藥的基礎上,治療組外敷德莫林聯閤納米銀醫用抗菌敷料,對照組患者創麵則覆蓋0.5％碘伏油紗佈,比較兩組患者創麵愈閤情況、創麵愈閤時間和創麵菌培養暘性率. 結果 治療組平均治療時間(41.6±2.7)d,明顯短于對照組(61.9±2.9)d(t=35.09,P=0.000);治療組患者入院時、入院14d和28 d細菌培養暘性率分彆為88.46％、23.07％和15.38％,對照組分彆為88.89％、59.26％和40.74％(x2=0.01、6.88、7.34,P=0.065、0.008、0.006).對照組47例患者有效率63.83％ (30/47),顯著低于治療組82.61％(38/46)(x2=4.17,P=0.035).按瓦格納(Wanger)繫統對糖尿病足病變嚴重程度進行分級,治療組27例2級病變患者有效率為88.89％(24/27),顯著高于對照組67.86％(18/28)(x2 =4.60,P=0.032);3級病變治療組19例有效率為73.86％(14/19),與對照組的63.15％(12/19)比較,差異無統計學意義(x2=0.49,P=0.364). 結論 德莫林聯閤納米銀醫用抗菌敷料能改善2級糖尿病足部慢性潰瘍的愈閤,但對于3級以上病變效果不明顯.
목적 관찰피부창면무궤유도활성부료(덕막림)연합납미은의용항균부료치료노년당뇨병환자족부만성궤양적료효. 방법 공수치노년당뇨병족부만성궤양환자93례,수궤장환자분성치료조화대조조,량조환자재진행내과치료화국부환약적기출상,치료조외부덕막림연합납미은의용항균부료,대조조환자창면칙복개0.5％전복유사포,비교량조환자창면유합정황、창면유합시간화창면균배양양성솔. 결과 치료조평균치료시간(41.6±2.7)d,명현단우대조조(61.9±2.9)d(t=35.09,P=0.000);치료조환자입원시、입원14d화28 d세균배양양성솔분별위88.46％、23.07％화15.38％,대조조분별위88.89％、59.26％화40.74％(x2=0.01、6.88、7.34,P=0.065、0.008、0.006).대조조47례환자유효솔63.83％ (30/47),현저저우치료조82.61％(38/46)(x2=4.17,P=0.035).안와격납(Wanger)계통대당뇨병족병변엄중정도진행분급,치료조27례2급병변환자유효솔위88.89％(24/27),현저고우대조조67.86％(18/28)(x2 =4.60,P=0.032);3급병변치료조19례유효솔위73.86％(14/19),여대조조적63.15％(12/19)비교,차이무통계학의의(x2=0.49,P=0.364). 결론 덕막림연합납미은의용항균부료능개선2급당뇨병족부만성궤양적유합,단대우3급이상병변효과불명현.
Objective To evaluate the effect of Dermlin,an inorganic activity induced skin wound dressing,in combination with a nano-silver dressing,on chronic diabetic foot ulcer.Methods A total of 93 elderly diabetic patients with chronic foot ulcer were recruited and randomly assigned into the treatment group and the control group.In additional to routine systemic and topical treatment for both groups,the treatment group was given a combination of Dermlin and nano silver dressngs,while for the control group,iodophor gause was used to cover the ulcer.The two groups were compared on ulcer grading,wound healing time and positive rate of bacterial culture.Results The wound healing time in the treatment group was significantly shorter than that in the control group [(41.6±2.7) d vs.(61.9±2.9) d,t=-35.09,P=0.000].Positive rates of bacterial culture for the treatment group at admission,14 d after admission and 28 d after admission were 88.46％,23.07％ and 15.38％,respectively,in contrast to 88.89％,59.26％ and 40.74,respectively,for the control group at the same time points (x2 =0.01,6.88,7.34,P=0.065,0.008,0.006).The rate of effectiveness for the control group was 63.83％ (30/47),clearly lower than the 82.61％ for the treatment group (38/46) (x2=4.17,P=0.035).The patients' foot ulcers were graded using the Wagner system.In the treatment group,27 patients with grade 2 ulcers showed an 88.89％effectiveness rate (24/27),considerably higher than the rate of 67.86％ in the control group (18/28)(x2=4.60,P=0.032).For grade 3 ulcers,the effectiveness rate was 73.86％ (14/19) for the treatment group and 63.15％ for the control group (12/19),with no statistical difference between the two groups (x2=0.49,P=0.364).Conclusions The combination of Dermlin and Nanosilver can promote healing for grade 2 chronic diabetic foot ulcers,but has no obvious effect on grade 3 ulcers.
