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目的观察负压封闭引流(vacuum sealing drainage,VSD)联合新鲜冰冻血浆(fresh frozen plasma,FFP)灌注治疗糖尿病足溃疡的临床疗效。方法收集2014-08/2016-07月解放军169医院烧伤整形科收治的糖尿病足溃疡(Wagner分级为Ⅱ~Ⅳ级)患者32例。所有患者均常规进行手术清创。术后采用随机数字表法将患者分为两组:VSD组(n=16)和VSD+FFP组(n=16)。待创面床准备完毕后采用游离薄中厚皮片移植术封闭创面。观察两组治疗后创面床准备时间,创面愈合时间,治疗10d后细菌清除率,移植皮片存活率。结果 32例患者糖尿病足溃疡均全部愈合。VSD+FFP组创面床准备时间及创面愈合时间均短于VSD组,组间比较差异具有统计学意义(P<0.05);VSD+FFP组治疗10 d后细菌清除率及移植皮片存活率均高于VSD组,组间比较差异具有统计学意义(P<0.05)。结论治疗糖尿病足溃疡时,VSD+FFP治疗优于单独应用VSD,能够缩短创面床的准备时间,提高细菌清除率,增加移植皮片存活率,促进创面愈合,值得进一步研究与临床推广。
Objective To observe the clinical efficacy of vacuum sealing drainage (VSD) and fresh frozen plasma (FFP) perfusion in the treatment of diabetic foot ulcer. Methods Thirty-two patients with diabetic foot ulcers (Wagner grades Ⅱ ~ Ⅳ) were enrolled in Department of Burn and Plastic Surgery, People’s Liberation Army 169 Hospital from August 2014 to July 2016. All patients were routinely debridement surgery. Patients were divided into two groups according to random number table: VSD group (n = 16) and VSD + FFP group (n = 16). After the wound bed preparation is completed, the wounds are closed with free thin-graded skin grafts. The wound bed preparation time, wound healing time, bacterial clearance after 10 days of treatment and graft skin graft survival rate were observed after treatment. Results 32 cases of diabetic foot ulcers were all healed. VSD + FFP group wound bed preparation time and wound healing time were shorter than the VSD group, the difference between the groups was statistically significant (P <0.05); VSD + FFP group after 10 d of bacterial clearance and graft survival rate were Higher than the VSD group, the difference between the groups was statistically significant (P <0.05). Conclusion VSD + FFP treatment is superior to VSD alone in the treatment of diabetic foot ulcers, which can shorten the preparation time of wound bed, increase the bacterial clearance rate, increase the survival rate of graft skin graft and promote the wound healing. It is worth further study and clinical promotion.