目的 研究重组人表皮生长因子结合银离子敷料在负压封闭引流(vacuum sealing drainage,VSD)环境下对糖尿病足溃疡创面的治疗效果。方法 选取2型糖尿病足感染患者129例,随机分为3组,每组各43例,A组单纯使用银离子敷料治疗,B组在银离子敷料治疗基础上添加重组人表皮生长因子(rhEGF)治疗,C组在A和B组基础上增加VSD负压引流,观察治疗28 d后三组患者创面治疗效果。结果 三组治疗总有效率分别为:A组88.4％(38/43)、B组93.0％(40/43)、C组97.7％(42/43),差异有统计学意义(P<0.05),治疗后疼痛效果评分(VAS):C组(银离子敷料+ rhEGF+VSD)的疼痛分值明显低于B组(银离子敷料+ rhEGF)和A组(银离子敷料),差异有统计学意义(P<0.05);从创面修复情况、换药次数和抗生素使用情况对比发现,C组明显优于A组和B组。结论 重组人表皮生长因子(rhEGF)结合银离子敷料在负压封闭引流下(VSD)治疗糖尿病足,创面愈合时间短、肉芽生长速度快、疗效显著,值得临床推广应用。
Abstract
Objective To study the therapeutic effect of recombinant human epidermal growth factor combined with silver ion dressings under vacuum sealing drainage (vacuum sealing drainage, the VSD) against diabetic foot ulcer wound. Methods A total of 129 patients with diabetic foot infection treated between September 2016 and February 2019 were selected and randomly divided into three groups, with 43 cases in each. Patients in group A were treated with silver ion dressings alone, group B was additionally given recombinant human epidermal growth factor (rhEGF), while group C received vacuum sealing drainage plus the two treatments mentioned above. Wound healing was compared between the three groups after 28 days of treatment. Results The effective rate was respectively 88.4% (38/43) in group A, 93% (40/43) in group B, and 97.7% (42/43) in group C, so the difference was statistically significant (P<0.05).The VAS of group C was significantly lower than that of group B and group A, with statistically significant difference (P<0.05).In terms of wound repair, times the dressing was changed and usage of antibiotics, group C was superior to group A and group B. Conclusions The combination of recombinant human epidermal growth factor (rhEGF) with silver ions dressing under vacuum sealing drainage (VSD), when used in the treatment of diabetic foot ulcer, can effectively promote healing and granulation, so it is worthy of clinical application.
关键词
重组人表皮生长因子 /
银离子敷料 /
糖尿病足 /
负压封闭引流 /
溃疡
Key words
human recombinant epidermal growth factor /
silver ion dressing /
diabetic foot /
vacuum seal drainage /
ulcer
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参考文献
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基金
北京市科技计划项目(Z161100000116056)
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