| 马 庆,鹿 亮,刘 彬,曾健学,陈伟健.Masquelet技术保肢治疗Wagner2-4型糖尿病足溃疡的临床研究[J].,2024,(16):3093-3097 |
| Masquelet技术保肢治疗Wagner2-4型糖尿病足溃疡的临床研究 |
| Clinical Study on Limb Salvage Treatment of Wagner Grades 2-4 Diabetic Foot Ulcers using Masquelet Technique |
| 投稿时间：2024-02-06 修订日期：2024-02-28 |
| DOI：10.13241/j.cnki.pmb.2024.16.018 |
| 中文关键词: Masquelet技术 糖尿病足 聚甲基丙烯酸甲酯 |
| 英文关键词: Masquelet technique Diabetic foot Poly - methyl methacrylate |
| 基金项目:国家自然科学基金项目（82102601） |
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| 中文摘要: |
| 摘要 目的：探究Masquelet技术保肢治疗Wagner2-4型糖尿病足溃疡的临床疗效。方法：回顾性分析2021年3月-2023年3月期间中国科学技术大学附属第一医院手足外科和内分泌科收治符合纳入标准的共计98例Wagner2-4型的糖尿病足溃疡病人，根据治疗方式不同分为聚甲基丙烯酸甲酯（Polymethylmethacrylate, PMMA）组（n=49）与负压封闭引流（Vacuum Sealing Drainage, VSD）组（n=49）。研究组行常规清创联合抗生素PMMA治疗；VSD组行常规清创联合VSD治疗。统计并比较两组患者治疗前后的分泌物病原学培养结果、疼痛视觉模拟评分（Visual Analogue Scale, VAS）、美国足踝医师协会（American Orthopaedic Foot & Ankle Society, AOFAS）评分、创面愈合时间、截肢率、创面愈合方式、溃疡复发率及总体住院时间。结果：所有病人均获得3月至2年随访，两组患者在创面分泌物病原学检测结果无统计学差异（P＞0.05），PMMA组治疗3个月后AOFAS评分明显高于VSD组（P<0.05），VAS评分明显低于VSD组（P<0.05）；PMMA总住院时间、创面愈合时间、截肢率、溃疡复发率明显低于VSD组（P<0.05）。结论：糖尿病足溃疡经Masquelet技术治疗后具有优良的创面愈合率及保肢率，效果肯定，值得推广。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical efficacy of limb salvage treatment for Wagner grades 2-4 diabetic foot ulcers using the Masquelet technique. Methods: A retrospective analysis was performed on 98 patients with Wagner grades 2-4 diabetic foot ulcers admitted to the Department of Hand and Foot Surgery and Endocrinology of the First Affiliated Hospital of USTC between March 2021 and March 2023. Patients were divided into two groups: the Polymethylmethacrylate (PMMA) group (n=49) and the Vacuum Sealing Drainage (VSD) group (n=49). The study group underwent conventional debridement combined with antibiotic PMMA treatment, while the VSD group underwent conventional debridement combined with VSD treatment. The secretion microbiological culture results, Visual Analogue Scale (VAS) pain scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, wound healing time, amputation rate, wound healing methods, ulcer recurrence rate, and overall hospital stay duration were statistically compared between the two groups. Results: All patients were followed up from 3 months to 2 years. There was no statistically significant difference in wound secretion microbiological findings between the two groups(P>0.05). Three months post-treatment, the AOFAS scores in the PMMA group were significantly higher than those in the VSD group (P<0.05), while the VAS scores were significantly lower(P<0.05). The overall hospital stay duration, wound healing time, amputation rate, and ulcer recurrence rate in the PMMA group were significantly lower than those in the VSD group(P<0.05). Conclusion: Diabetic foot ulcers treated with the Masquelet technique show excellent rates of wound healing and limb salvage. The results are promising and worth promoting. |
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