自体富血小板凝胶联合封闭式负压引流术治疗糖尿病足溃疡的效果观察

摘要

目的 分析自体富血小板凝胶(autologous platelet-rich gel,APG)联合封闭式负压引流术(vacuum sealing drainage,VSD)治疗糖尿病足溃疡的效果,为临床治疗提供依据.方法 选取2014年1月至2017年1月于本院住院治疗的72例糖尿病足溃疡患者为研究对象.将患者依据随机数表法分为观察组(36例)和对照组(36例).观察组患者给予APG联合VSD治疗,对照组患者仅给予VSD治疗.比较两组患者的疗效和溃疡愈合时间;采用酶联免疫吸附测定检测并比较两组患者治疗前1天、治疗12天和24天后创面肉芽组织中血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)和碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)表达情况.结果 观察组患者治疗总有效率显著高于对照组(P<0.05),溃疡愈合时间显著短于对照组(P<0.05).治疗12天和24天后,两组患者肉芽组织中VEGF和bFGF表达水平均显著高于治疗前1天(P<0.05);治疗24天后,两组患者肉芽组织中VEGF和bFGF水平均显著高于治疗12天后(P<0.05).治疗12天和24天后,观察组患者肉芽组织中VEGF和bFGF水平均高于同时间点对照组患者(P<0.05).结论 APG联合VSD治疗糖尿病足溃疡,疗效显著,能够有效促进肉芽组织中血管生成,缩短溃疡愈合时间.%Objective To study the therapeutic effect of autologous platelet-rich gel (APG) combined with vacuum sealing drainage (VSD) in the treatment of foot ulcers of patients with diabetes, and to provide the basis for clinical treatment. Method 72 patients with diabetic foot attended in our hospital from January 2014 to January 2017 were enrolled in this study and randomly divided into observation group (36 cases) and control group (36 cases). Observation group patients were treated by APG combined with VSD, and control group patients were treated by VSD alone. The therapeutic effect and healing time were observed and compared between the two groups. The expression level of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in the granulated tissue of the ulcers were measured by enzyme-linked imm unosorbent assay at 1 day before treatment, 12 days and 24 days after treatment. Result The therapeutic rate of observation group was significantly higher than control group (P < 0.05), the healing time was significantly shorter than control group (P < 0.05). The expression levels of VEGF and bFGF in both groups at 12 days and 24 days after treatment increased significantly compared with 1 day before treatment (P < 0.05). The expression levels of VEGF and bFGF in both groups at 24 days after treatment increased significantly compared with 12 days after treatment (P < 0.05). The expression levels of VEGF and bFGF in observation group at 12 days and 24 days after treatment increased significantly compared with those in control group at the same time (P < 0.05). Conclusion APG combined with VSD is effective in the treatment of diabetic foot, and can effectively promote angiogenesis in granulation tissue and shorten the healing time of ulcer.