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目的评价超声清创术对糖尿病足溃疡创面细菌的清除作用及对微循环的影响,探讨其可能的促愈机制。方法采用随机对照法将2008年5月至2009年2月住院的糖尿病足患者24例分为标准治疗+普通冲洗组(ST组)和标准治疗+超声清创组(SU组)各12例,分别对两组治疗20d内溃疡愈合速度、创面微循环改变及创面细菌清除作用进行比较。结果 (1)SU组第20天平均创面愈合速率[(0.87±0.11)%]显著快于ST组[(0.65±0.14)%](P<0.05)。(2)SU组治疗后创面平均血流灌注量[(0.91±0.18)PU]及经皮氧分压[(34.66±6.08)mmHg]显著高于ST组[(0.80±0.19)PU和(32.83±6.97)mmHg](P均<0.05)。(3)SU组治疗后创面细菌量显著少于ST组(P<0.05)。结论超声清创术可通过减轻伤口细菌负荷及促进创面微循环,而促进糖尿病足的伤口愈合。
Objective To evaluate the effect of ultrasonic debridement on bacterial clearance and microcirculation of diabetic foot ulcer wounds and to explore its possible mechanism of promoting healing. Methods Twenty-four patients with diabetic foot admitted to hospital from May 2008 to February 2009 were divided into standard treatment group (ST group) and standard treatment group (ultrasound group) The healing rates of ulcer, the changes of wound microcirculation and the bacterial clearance of wounds were compared between the two groups in 20 days. Results (1) The mean wound healing rate on the 20th day in SU group [(0.87 ± 0.11)%] was significantly faster than that in ST group [(0.65 ± 0.14)%] (P <0.05). (2) The mean perfusion of wound ([0.91 ± 0.18] PU] and transcutaneous oxygen pressure [(34.66 ± 6.08) mmHg] in SU group were significantly higher than those in ST group [(0.80 ± 0.19) PU and (32.83 ± 6.97) mmHg] (all P <0.05). (3) The bacterial counts of wounds in SU group were significantly less than those in ST group (P <0.05). Conclusion Ultrasonic debridement can promote the wound healing of diabetic foot by reducing the bacterial load of the wound and promoting the microcirculation of the wound.