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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:

期数:

2024年3期

页码:

61-64

栏目:

出版日期:

2024-03-10

文章信息/Info

Title:

Negative Pressure Drainage Combined with Silver Ion Hydrogel Dressing for the Treatment of Chronic Skin Infection Wounds of Lower Extremities with Type 2 Diabetes Mellitus

文章编号:

1008-6455(2024)03-0060-04

作者:

谢银花; 刘 瑾; 何 润

(绵阳市中心医院伤口治疗中心 四川 绵阳 621000 )

Author(s):

XIE Yinhua; LIU Jin; HE Run

(Wound Treatment Center,Mianyang Central Hospital,Mianyang 621000,Sichuan,China)

关键词:

负压引流; 银离子水凝胶; 2型糖尿病; 慢性感染伤口; 创面愈合; 氧化应激反应

Keywords:

negative pressure wound treatment;  silver ionic hydrogel;  type 2 diabetes;  chronic infected wound;  wound healing;  oxidative stress reaction

分类号:

R605

文献标志码:

A

摘要:

目的：探讨负压引流联合银离子水凝胶敷料治疗对2型糖尿病患者下肢皮肤慢性感染伤口愈合的影响。方法：选取 2020 年4月-2022年5月笔者医院收治的99例2型糖尿病下肢皮肤慢性感染伤口患者为研究对象，采用随机数字表法分为敷料 组、负压引流组、联合组，各33例。敷料组采用银离子水凝胶外敷治疗，负压引流组采用伤口负压引流治疗，联合组采用负 压引流联合银离子水凝胶敷料治疗。统计三组创面愈合时间、肉芽组织形成时间、上皮组织形成时间，比较三组治疗前、治 疗7 d、14 d疼痛情况及治疗前、治疗7 d创面渗液血管内皮生长因子（Vascular endothelial growth factor,VEGF）、基质 金属蛋白酶-9（Matrix metallo proteninases-9,MMP-9 ）、组织型金属蛋白酶抑制剂-1（Tissue inhibitor of metallo proteinase-1,TIMP-1 ）、血清白细胞介素-6（Interleukin-6,IL-6）、肿瘤坏死因子-α(Tumor narcosis factorα,TNF-α)、白细胞介素-8（Interleukin-8,IL-8）、超氧化物歧化酶（Superoxide dismutase,SOD）、硫代巴比妥酸法 检测丙二醛（Malondialdehyde,MDA）、晚期蛋白氧化产物（Advanced oxidation protein products,AOPP）水平。结果： 三组创面愈合时间、肉芽组织形成时间、上皮组织形成时间均联合组＜负压引流组＜敷料组（P＜0.05）；治疗7、14 d， 三组VAS评分联合组＜负压引流组＜敷料组（P＜0.05）；治疗7 d，三组VEGF、TIMP-1水平较治疗前升高，且联合组＞负压 引流组＞敷料组，MMP-9水平较治疗前降低，且联合组＜负压引流组＜敷料组（P＜0.05）；治疗7 d，联合组血清IL-8、 TNF-α 、IL-6水平低于负压引流组、敷料组（P＜0.05）；治疗7 d，联合组SOD水平高于负压引流组、敷料组，MDA、AOPP水 平低于负压引流组、敷料组（P＜0.05）。结论：负压引流联合银离子水凝胶辅料治疗能减少2型糖尿病下肢皮肤慢性感染伤 口患者创面MMP-9含量，增加VEGF、TIMP-1含量，减轻炎症反应和氧化应激反应，有助于促进伤口愈合，减轻疼痛程度。

Abstract:

Objective To investigate the effect of negative pressure wound therapy combined with silver ionized hydrogel on wound healing in type 2 diabetic patients with chronic skin infections in the lower extremities. Methods Ninety-nine patients with chronic infected wounds in the lower limb skin of type 2 diabetes admitted to the author’s hospital from April 2020 to May 2022 were selected for the study.They were divided into group A,group B and group C with 33 cases in each group by random number table method.Group A received silver ionized hydrogel,group B received negative pressure wound treatment,and group C received negative pressure wound treatment combined with silver ionized hydrogel.The wound healing time,granulation tissue formation time,and epithelial tissue formation time of the three groups were counted.The pain score of the three groups before treatment,7 days and 14 days after treatment were compared.The levels of vascular endothelial growth factor (VEGF),matrix metalloproteinase-9 (MMP-9),tissue metalloproteinase-1 (TIMP-1) and serum interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),interleukin-8 (IL-8),Superoxide dismutase (SOD),malondialdehyde (MDA),and advanced oxidation protein products (AOPP) in wound exhalation were compared between the three groups before treatment and 7 days after treatment. Results The wound healing time,granulation tissue formation time,and epithelial tissue formation time of the three groups were combined group ＜ negative pressure drainage group ＜ dressing group (P ＜0.05).On treatment day 7 and 14,the VAS scores of the three groups were all lower than those of combined group ＜ negative pressure drainage group ＜ dressing group (P ＜0.05). After 7 days of treatment,the levels of VEGF and TIMP-1 in the three groups were higher than those before treatment,and the combined group ＞ negative pressure drainage group ＞ dressing group,and the level of MMP-9 was lower than that before treatment,and the combined group ＜ negative pressure drainage group ＜ dressing group (P ＜0.05). On the 7th day of treatment,the serum levels of IL-8,TNF-α,and IL-6 in the combination group were lower than those in the negative pressure drainage group and the dressing group (P ＜0.05). On treatment day 7,the SOD level in the combined group was higher than that in the negative pressure drainage group and dressing group,and the MDA and AOPP levels were lower than those in the negative pressure drainage group and dressing group (P ＜0.05). Conclusion Negative pressure wound treatment combined with silver ionized hydrogel can reduce the content of MMP-9,increase the content of VEGF and TIMP-1,reduce infl ammatory response and oxidative stress response,and help promote wound healing and alleviate pain in patients with type 2 diabetes with chronic infected wounds of lower limb skin.

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更新日期/Last Update: 2024-03-20