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目的:观察超声清创配合中药熏蒸疗法对糖尿病足肉芽组织病理结构的影响。方法:将60例糖尿病足1级、2级患者随机分为2组,超声清创联合中药熏蒸30例,常规外科换药联合中药熏蒸30例。治疗3周期间分别于第1、7、14、21天各组取病理标本观察创面肉芽组织生长情况,从新生毛细血管、成纤维细胞、巨噬细胞的数目变化、炎性细胞浸润等角度与对照组进行比较,同时治疗3周后比较各组创面缩小率、治愈率。结果:对照组溃疡创面炎症细胞、成纤维细胞出现晚;炎症持续时间长,各种细胞器不丰富,且功能不活跃。治疗组溃疡创面肉芽组织中炎性细胞出现早,炎症持续时间短;淋巴细胞、成纤维细胞增多;各种细胞细胞器丰富,功能活跃。治疗组创面面积缩小率为90%,治愈率73.3%;对照组创面缩小率80.0%,治愈率60.0%。治疗组创面缩小率和治愈率均高于对照组(P<0.05)。结论:超声清创联合中药熏蒸疗法对糖尿病足难治性溃疡创面有促进肉芽组织增生提高疗效的作用。
Objective: To observe the effect of ultrasonic debridement and traditional Chinese medicine fumigation therapy on pathological structure of diabetic foot granulation tissue. Methods: Sixty diabetic patients with stage 1 and 2 were randomly divided into 2 groups. 30 cases were treated with ultrasonic debridement and traditional Chinese medicine fumigation, and 30 cases were treated by conventional surgical dressing and traditional Chinese medicine fumigation. During the first 3 weeks of treatment, pathological specimens were collected on the 1st, 7th, 14th and 21st day respectively to observe the growth of wound granulation tissue. From the perspectives of the number of newborn capillaries, fibroblasts and macrophages, inflammatory cell infiltration The control group were compared, while 3 weeks after treatment, the rate of wound shrinkage and the cure rate in each group were compared. Results: In the control group, inflammatory cells and fibroblasts in ulcer wound appeared late. Inflammation lasted for a long time and various organelles were not abundant, and the function was not active. Inflammatory cells in the granulation tissue of the treatment group appeared earlier and the duration of inflammation was shorter; lymphocytes and fibroblasts increased; various organelles were abundant and active. In the treatment group, the wound area reduction rate was 90% and the cure rate was 73.3%. In the control group, the wound reduction rate was 80.0% and the cure rate was 60.0%. The reduction rate and cure rate of wounds in the treatment group were higher than those in the control group (P <0.05). Conclusion: Ultrasonic debridement combined with traditional Chinese medicine fumigation therapy can improve the curative effect of granulation tissue proliferation in diabetic foot refractory ulcer wounds.