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1、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I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I薛耀明I赖西南2高方I沈洁I谢翠华I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
2、±0.14(Pv().O5)。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(PvO.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StudyonthemechanismofultrasounddebridementtopromotethehealingofdiabeticfootulcerCaoying1,Xueyaoming1,
3、Laixinan2,Gaofang1,Shenjie1,Xiecuihua1.'Depiirtmentof2Endocrinology,NanfangHospital,SouthernMedicalUniversity,Guangzhou,Guangdong.510515,ResearchInstituteofSurgery,ThirdMilitaryMedicalUniversityAbstractObjectToevaluatetheeffectofultrasounddebridementapparatusinthetreatmentofdiabeticfootulceran
4、dstudytheprobablemechanismofhealingpromotion.Methods24patientswithdiabeticfootulcer,whohospitalizedfromMay,2008toFebruary,2009,wererandomizedintostandardtherapygroupandstandardtherapyplusultrasounddebridementgroup(ultrasounddebridementgroup)・Therewere12patientsineachgroup.Thespeedofulcerhealin
5、g,microcirculationchangeofwoundsurface,bacterialonwoundsurfacein20dayswerecomparedbetweenthetwogroups.Results:1,Theaveragehealingspeedofwoundsurfaceonday20ofultrasounddebridementgroupandstandardtherapygroupwere0.87±0」1and0.65±0.14respectively,theformerweresignificantlyhiger.(P<0.05).2,Theavera
6、gebloodperfusionvolumeofwoundsurfaceandtranscutaneousoxygenpressureofultrasounddebridementgroupwere0.91±0.18PUand34.66土6.08respectively,whichsignificantlyhigherthanthose(0.80土0.19PU,32.83士6.97)ofstandardtherapygroup(PvO.05).3,Thebacterialcountsonwoundsurfaceofultrasounddebridementgroupweresign
7、ificantlylesslhanthoseofstandardtherapygroup(PvO.05).ConclusionUltrasounddebridementcanpromotethehealingofdiabeticfootulcerthroughdecreasingthebacterialloadofwoundsurfaceandacceleratingthemicrocirculationofwoundsurface.Keywordsultrasoun
