摘要
目的 探讨糖尿病足溃疡患者坚持踝泵运动治疗对足部溃疡面愈合的影响.方法采用便利抽样法,选取在天津医科大学代谢病医院糖尿病足科2015年7—12月住院且符合纳入排除标准的患者作为对照组,2016年5—10月住院且符合纳入排除标准的患者作为观察组.共入组162例患者,最终有156例完成研究,观察组72例,对照组84例.对照组患者给予糖尿病足常规治疗和护理,观察组在此基础上给予踝泵运动训练.治疗9周后,比较治疗前后两组患者足溃疡的面积、愈合情况、经皮氧分压、足部皮温、踝肱指数,并记录两组整个过程中的不良事件.结果治疗9周后,两组患者的足部溃疡面积均减小,治疗前后相比差异均有统计学意义（P〈0.01）.治疗后观察组溃疡面积减少高于对照组,差异有统计学意义（P〈0.01）.治疗后观察组和对照组Wagner分级Ⅲ、Ⅳ的患者经皮氧分压、皮温,观察组Wagner分级Ⅲ级的患者踝肱指数均较治疗前升高,差异均有统计学意义（P〈0.05）.治疗前两组经皮氧分压、踝肱指数、皮温差异无统计学意义（P〉0.05）;治疗后观察组中Wagner分级Ⅱ级的患者皮温和踝肱指数均较对照组高,差异均有统计学意义（P〈0.01）,Wagner分级Ⅲ级的患者经皮氧分压和皮温均较对照组高,差异均有统计学意义（P〈0.01）,Wagner分级Ⅳ级的患者经皮氧分压较对照组高,差异有统计学意义（P〈0.01）.观察组、对照组各有4例患者出现无症状低血糖症状,不良事件发生率差异无统计学意义（P〉0.05）.观察组溃疡面愈合率高于对照组,差异无统计学意义（χ2=3.714,P=0.054）.结论踝泵运动方法对糖尿病足溃疡创面愈合起着积极的作用,具有较高的安全性.
Objective To explore the effect of ankle pump on wound healing of diabetic foot ulcer （DFU）. Methods Using convenience sampling method, patients hospitalized in Podiatry Department of Tianjin Medical University Metabolic Diseases Hospital from July to December 2015 and eligible for inclusion-exclusion criteria were recruited to control group, and patients who were hospitalized from May to October 2016 were recruited to observation group according inclusion-exclusion criteria. A total of 162 patients with DFU were recruited and 156 patients completed the whole study, with 72 cases in observation group and 84 cases in control group. Routine treatment and nursing care of DFU were given to both groups, and on the basis of that ankle pump motion therapy training was given to the observation group. After treatment for 9 weeks, the foot ulcer area, healing condition, transcutaneous arterial oxygen tension （TcPO2）, foot skin temperature and ankle brachial index （ABI） were compared. In addition, the adverse events throughout the process of the two groups were recorded. Results After 9-week treatment, the healing rate of observation group was higher than the control group, and the difference wasn＇t statistically significant （χ2=3.714, P=0.054）. The area of foot ulcer of both groups decreased, and the difference wasn＇t statistically significant before and after treatment （P〈0.01）. Ulcer surface area in the intervention group decreased more significantly after treatment than the control group（P〈0.01）. Wagner grading Ⅲ, Ⅳ patients＇ TcPO2, skin temperature of both groups,and wagner grading Ⅲ patients＇ ABI of oberservation group all increased than before treatment, with statistical difference （P〉 0.05）. There was no statistical difference of TcPO2, ABI and skin temperature between the two groups before treatment （P〉 0.05）. In observation group, Wagner grading Ⅱ patients＇ skin temperature and ABI, Wagner grading Ⅲ patients＇ TcPO2 and skin temperature, Wagner grading Ⅳ patients＇ TcPO2were all higher than those of the control group, with statistical difference （P〈0.01）. There were 4 cases of asymptomatic hypoglycemia in each group, and there was no statistical difference of adverse event in both groups. Conclusions The ankle pump motion has a positive effect on the wound healing of DFU, which has the advantage of high safety.
出处
《中华现代护理杂志》
2018年第2期147-151,共5页
Chinese Journal of Modern Nursing
基金
天津市卫生局科技基金（2015KZ090）
关键词
糖尿病足
溃疡
踝泵运动
Diabetic foot
Ulcer
Ankle pump motion
