活体五谷虫治疗慢性糖尿病足部溃疡创面的初步研究

发布时间：2018-11-04 21:32

【摘要】：目的:慢性糖尿病足部溃疡病程长、疗效差、常合并感染,长期抗感染治疗易导致机体对抗生素不敏感。本研究拟评估一种新型的生物疗法——活体五谷虫清创对慢性糖尿病足部溃疡的疗效。方法:本研究从自2013年7月至2013年11月期间于外科门诊常规换药治疗的糖尿病足部溃疡迁延不愈而其他保守治疗无效患者中选取受试者。选取符合纳入标准,而不符合排除标准的患者14人,详细向其和家属解释本临床研究的目的和流程,说明基本的研究方法,将愿意参加本次研究的患者随机分组。将应用五谷虫生物清创的患者作为实验组,而将常规换药治疗的患者编为对照组。医嘱两组患者每日于门诊更换溃疡处敷料并记录其创面每日恢复情况,取其分泌物做菌培养。五谷虫治疗组每日换药同时仔细计数从创面取出的虫体数量,与前一日换药放置的虫体数量做对比。对照组患者则行医院常规换药,病情需要时给予外科清创治疗。以溃疡处分泌物细菌培养转阴时间、创面肉芽出现时间和溃疡愈合时间为评估指标。使用SPSS20.0统计分析数据,并结合其伴随疾病深入分析五谷虫治疗与创面愈合的关系。本研究中,双侧检验P0.05,将视为有明显统计学差异。结果:1.本研究实际有效病例为13人,五谷虫生物清创治疗组为7人,常规换药组为6人,且两组数据基线资料一致。2.五谷虫治疗组细菌培养转阴时间明显少于常规换药治疗组,具有统计学意义(P值0.05)。3.五谷虫治疗组肉芽组织出现时间明显少于常规换药治疗组,具有统计学意义(P值0.05)。4.五谷虫治疗组创面完全愈合时间明显少于常规换药治疗组,具有统计学意义(P值0.05)。结论:活体五谷虫生物清创是治疗慢性糖尿病足部溃疡创面的一种有效方法,其疗效高于常规外科换药。
[Abstract]:Objective: chronic diabetic foot ulcers have long course of disease, poor curative effect, often complicated with infection, and long-term anti-infection treatment may lead to insensitivity to antibiotics. The aim of this study was to evaluate the efficacy of a new biotherapy-the debridement of gluten in vivo for chronic diabetic foot ulcers. Methods: from July 2013 to November 2013, subjects were selected from patients with diabetic foot ulcers who had been treated with routine dressing change from July 2013 to November 2013. Fourteen patients who met the inclusion criteria but did not meet the exclusion criteria were selected to explain to them and their families in detail the purpose and procedure of the clinical study and to explain the basic research methods. Patients who were willing to participate in the study were randomly divided into groups. The patients treated with biological debridement of gluten were used as the experimental group, while the patients treated with routine dressing change were divided into the control group. The two groups of patients were ordered to change the ulcer dressing and record the wound recovery every day. In the gluten treatment group, the number of worm bodies removed from the wound was counted carefully at the same time, which was compared with that of the previous day. The patients in the control group were treated with surgical debridement. The time of bacterial culture to negative, the time of granulation and the time of ulcer healing were used as the evaluation index. The relationship between the treatment of gluten and wound healing was analyzed by SPSS20.0 statistical analysis and combined with its concomitant diseases. In this study, bilateral test P0.05 will be considered to have a significant statistical difference. The result is 1: 1. The actual effective cases in this study were 13, 7 in the biological debridement treatment group and 6 in the routine dressing change group, and the baseline data of the two groups were the same. 2. The negative time of bacterial culture in the gluten treatment group was significantly shorter than that in the routine dressing change group (P 0.05). The time of granulation appeared in gluten treatment group was significantly shorter than that in routine dressing change group (P 0.05). The wound healing time in the gluten treatment group was significantly shorter than that in the routine dressing change group (P 0.05). Conclusion: the biological debridement of glutenella in vivo is an effective method for the treatment of chronic diabetic foot ulcer.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2

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