摘要
目的评价自体微粒皮肉芽创面移植对糖尿病足溃疡创面治疗的效果。方法自2021年6—12月,西安市第九医院烧伤整形外科收治46例WagnerⅢ、Ⅳ级糖尿病溃疡患者。根据治疗方法将患者分为两组,23例/组。对照组采用传统微粒皮移植治疗,干预组采用自体微粒皮肉芽组织创面移植治疗。在术前和术后2、4周分别采集创面组织。采用ELASA法测定组织匀浆中糖基化终产物(advanced glycation end products,AGEs)及晚期糖基化终产物受体(receptor of advanced glycation endproducts,RAGE)浓度,并比较创面治疗情况。结果两组患者治疗前一般情况、AGEs浓度、RAGE浓度、创面情况比较,差异均无统计学意义(P>0.05),具有可比性。对照组、干预组患者治疗后2、4周的创面面积,在各治疗节点均较治疗前缩小,但干预组缩小更显著(P<0.05);两组创面组织AGEs、RAGE浓度在各治疗节点均较治疗前降低,并且干预组优于对照组(P<0.05);干预组创面疗效有效率为95.7%,对照组有效率为69.6%,干预组效果更显著(P<0.05)。结论自体微粒皮肉芽组织创面种植治疗可以改善并促进糖尿病足溃疡创面的修复,显著降低AGEs及RAGE表达情况,为糖尿病足的临床及药物治疗提供理论依据。
Objective To evaluate the effect of microdermal granulation autologous wound transplantation in the treatment of diabetic foot ulcer.Methods From June 2021 to December 2021,46 patients with Wagner3-4 diabetic ulcer were admitted to the Department of Burn and Plastic Surgery in the Ninth Hospital of Xi'an.According to the treatment method,patients were divided into two groups,23 cases each group.The control group was treated with traditional microskin graf,and the intervention group was treated with au togenous microskin granulation wound graft.The wound tissue was collected before surgery and 2 and 4 weeks afier surgery.The concentration of advanced glycation endproducts(AGEs)and receptor of advanced glycation endproducts(RAGE)in tissue homogenates was determined by ELISA method,and the wounds treatment effect were compared.Results Before treatment,there was no statistical difference in the general situation,AGEs concentration,RAGE concentration and wound condition between the two groups(P>0.05),which was comparable.The wound area of 2 weeks and 4 weeks after the treatment in the control group and the intervention group was smaller than that before the treatment respectively,but the reduction was more significant in the intervention group(P<0.05).The concentrations of ACEs and RAGE in the wound tissue of the two groups were lower than before at all treatment nodes,and the intervention group was better than the control group(P<0.05).The effective rate of the intervention group was 95.7%.The effective rate of control group was 69.6%,and the effect of intervention group was more significant(P<0.05).Conclusion Autologous microgranular skin granulation implantation can improve and promote the repair of diabetic foot ulcer wounds,significantly reduce the expression of AGEs and RAGE,which provide theoretical basis for clinical and drug treatment of diabetic foot.
作者
赖海静
刘嘉铭
苏婧
周小茜
王鹏
蒋丽媛
王煜
马芯蕊
肖厚安
LAI Haijing;LIU Jiaming;SU Jing;ZHOU Xiooqian;WANG Peng;JIANG Liywan;WANG Yu;MA Xinrui;XIHouan(Department of Burn and Plasic Surgery,the Ninth Hospiral of Xi'an,Xi'an 710054,China)
出处
《中国美容整形外科杂志》
CAS
2023年第12期730-734,共5页
Chinese Journal of Aesthetic and Plastic Surgery
基金
中国红十字基金会徐荣祥再生生命公益基金科研课题(RXRL2021-05)
西安市科技计划项目(22YXYJ0078)。
关键词
自体微粒皮
肉芽组织创面移植
糖尿病足
晚期糖基化终末产物
效果评价
Autologous microskin
Granulation wound transplantation
Diabetic foot
Advanced glycation end products
Effect evaluation
