超声清创对糖尿病足溃疡创面细菌清除及微循环作用的临床研究.docVIP

超声清创对糖尿病足溃疡创面细菌清除及微循环作用的临床研究 1南方医科大学南方医院内分泌代谢科 2第三军医大学野战外科研究所 曹瑛1 薛耀明1 赖西南2 高方1 沈洁1 谢翠华1 摘要：目的 评价超声清创仪对糖尿病足溃疡创面细菌的清除作用及对微循环影响，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例随机分为标准治疗+普通冲洗组（简称标准治疗组）和标准治疗+超声清创组（简称超声清创组）各12例，分别对两组治疗20天内溃疡愈合速度、创面微循环改变及创面细菌清除作用的比较。结果1、超声清创组第20天平均创面愈合速率0.87±0.11，显著快于标准治疗组0.65±0.14(P0.05)。2、超声清创组治疗后创面平均血流灌注量0.91±0.18PU及经皮氧分压34.66±6.08显著高于标准治疗组的0.80 ±0.19和32.83±6.97（P均0.05）3、超声清创组治疗后创面细菌量显著少于标准治疗组（P0.05）。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。 关键词 超声清创 糖尿病足 细菌清除 微循环 愈合 Study on the mechanism of ultrasound debridement to promote the healing of diabetic foot ulcer Caoying1, Xue yaoming1, Lai xinan2, Gaofang1, Shenjie1, Xiecuihua1. 1Department of Endocrinology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong. 510515, 2 Research Institute of Surgery ,Third Military Medical University Abstract Object To evaluate the effect of ultrasound debridement apparatus in the treatment of diabetic foot ulcer and study the probable mechanism of healing promotion.Methods 24 patients with diabetic foot ulcer, who hospitalized from May, 2008 to February, 2009, were randomized into standard therapy group and standard therapy plus ultrasound debridement group (ultrasound debridement group). There were 12 patients in each group. The speed of ulcer healing, microcirculation change of wound surface, bacterial on wound surface in 20 days were compared between the two groups. Results: 1, The average healing speed of wound surface on day 20 of ultrasound debridement group and standard therapy group were 0.87?.11and0s.65?6.14respectively,the former were significantly higer.(P0.05). 2, The average blood perfusion volume of wound surface and transcutaneous oxygen pressure of ultrasound debridement group were 0.91?.18PU and 34.66?.08 respectively, which significantly higher than those (0.80?.19PU,32.83?.97) of standard therapy group (P0.05).3, The bacterial counts on wound surface of u Resltrasound debridement group were significantly less than