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胫骨横向骨搬移联合超声清创治疗糖尿病足

Treatment of Diabetic Foot with Transverse Tibial Bone Movement Combined with Ultrasonic Debridement

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【作者】 周家顺严芳杨颇宋开芳秦杰陶吕金鑫

【Author】 ZHOU Jia-shun;YAN Fang;YANG Po;SONG Kai-fang;QIN Jie;TAO Lv;JIN Xin;Department of Orthopedics, Section Three, Department of Trauma Surgery, Department of Hand Surgery, the Fourth People’s Hospital of Guiyang;

【机构】 贵阳市第四人民医院骨三科创伤外科手显外科

【摘要】 目的利用胫骨横向骨搬移联合超声清创治疗糖尿病足。方法在2015年3月—2017年3月期间,该院对7例糖尿病足患者,采用胫骨横向骨搬移联合超声清创治疗糖尿病足,同时配合换药、植皮、皮瓣修复等治疗。结果 7例患者,4例患者行胫骨横向骨搬移联合超声清创及换药治疗,病情获得痊愈;2例患者为缩短治疗周期行胫骨横向骨搬移及采用超声清创联合后行植皮处理,创面获得痊愈;1例患者因局部骨及肌腱外露采用胫骨横向骨搬移及超声清创仪治疗,并联合局部转移皮瓣修复获得痊愈;7例患者经胫骨横向骨搬移后,通过对治疗前后肢端的感觉、皮温、颜色、麻木、疼痛、对比,均较术前明显改善,3例患者术前术后做血管对比检查,发现肢体远端小血管网数量明显增加,创面愈合时间均较对未行骨搬移患者明显缩短;超声清创能清除创面上的坏死组织,有利于创面及肉芽生长,而且清创过程中患者均属于无痛型清创,疗效确切,操作简单,方便快捷。结论胫骨横向骨搬移联合超声清创治疗糖尿病足是一种可行而有效的方法,能在临床上取得卓越疗效,明显减少糖尿病足患者的截肢率及住院时间。

【Abstract】 Objective This paper tries to analyze treatment effect of diabetic foot with transverse tibial bone movement combined with ultrasonic debridement. Methods 7 patients with diabetic foot treated with transverse tibial bone movement combined with ultrasonic debridement from March 2015 to March 2017 were selected and treated with dressing, skin graft,and flap repair. Results Among the 7 patients, the condition of 4 patients with tibial transverse bone removal combined with ultrasound debridement and dressing treatment was improved; in order to shorten the treatment cycle, the wound surface of2 patients of tibial transverse bone removal and ultrasound debridement combined skin graft treatment was cured; 1 patient of local bone and tendon exposure implemented the tibial lateral bone removal and ultrasound debridement treatment and combined with local transfer flap repair was cured; after the tibial transverse bone removal, through the front and back of the treatment of 7 patients’ feeling, skin temperature, color, numbness, pain were significantly improved compared with those before operation; the vascular comparison test of 3 patients before and after surgery was conducted and found that the number of limb distal small blood vessels increased significantly, the wound healing time of bone removal was shorter than of that without bone removal; ultrasound debridement could remove the wound on the necrotic tissue, was conducive to the wound and granulation growth, and debridement process was painless, with exact curative effect, simple, convenient and quick operation. Conclusion Transverse tibial bone movement combined with ultrasonic debridement is a feasible and effective method for the treatment of diabetic foot. It can achieve excellent curative effect in clinic and reduce the amputation rate and length of stay of diabetic foot patients.

  • 【文献出处】 糖尿病新世界 ,Diabetes New World , 编辑部邮箱 ,2017年10期
  • 【分类号】R587.2
  • 【被引频次】4
  • 【下载频次】139
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