透明质酸锌凝胶在治疗糖尿病足创面中的应用

【】　目的　观察透明质酸锌凝胶治疗糖尿病足创面的疗效。　方法　2009年6月―2010年6月收治60例创面面积≤6cm2的糖尿病足患者，其中男41例，女19例；年龄49～80岁，平均58岁。糖尿病病程4～20年，糖尿病足病程2～12周。按照糖尿病足Wagner分级标准进行分级为Ⅰ、Ⅱ、Ⅲ级（每级各20例）。将患者随机分为治疗组和对照组，每组30例，每级各10例。两组患者性别、年龄、病程及创面比较差异均无统计学意义（P>0.05），具有可比性。两组患者均常规给予胰岛素或降糖药控制血糖，并同时给予抗炎、改善微循环及营养支持治疗。处理上治疗组加用透明质酸锌凝胶，对照组仅常规换药，治疗后4、8周观察两组创面愈合情况。　结果　治疗组8周时治愈率为53.3%，总有效率为96.7%；对照组治愈率为30.0%，总有效率为60.0%；两组总有效率比较差异有统计学意义（P0.05)sothattheywerecomparable.Allpatientswereroutinelyofferedwithinsulinorothermedicinetocontrolbloodsugarlevel,andatthesametimetheyacceptedanti-inflammatory,microcirculationimprovingandnutritionsupportingtreatments.Zinchyaluronatewasaddedtothetreatmentofthepatientsinthetreatmentgroup,whilethecontrolgroupunderwentconventionaltreatment.Woundhealingconditionwasobserved4and8weeksafterthebeginningofthetreatment.　Results　Atweekeight,thecurerateforthetreatmentgroupwas53.3%,andthetotaleffectiveratewas96.7%;thetwonumbersforthecontrolgroupwererespectively30.0%and60.0%.Therewasasignificantdifferencebetweenthetwogroupsinthetotaleffectiveness(P<0.05).ThecurerateandtotaleffectiverateforgradeⅡandⅢwoundinthetreatmentgroupwerebetterthanthoseinthecontrolgroup(P<0.01).Coagulanttimeforthetreatmentgroupandthecontrolgroupwasrespectively(23.25±8.52)daysand(29.16±9.20)dayswithasignificantdifference(P<0.05).Nostatisticaldifferencewasfoundinthebacteriaculturesbetweenthetwogroupsaftertreatment.　Conclusions　Usingzinchyaluronateindiabeticfoottreatmentcanobviouslyprotectthewoundandpromotewoundhealing.Itisagoodchoicefordiabeticfootwoundhealing.