自体富血小板凝胶联合冷沉淀制剂对糖尿病足溃疡患者创面愈合、血管生成因子及生活质量的影响

目的:探讨自体富血小板凝胶联合冷沉淀制剂对糖尿病足溃疡患者创面愈合、血管生成因子及生活质量的影响。方法:选取西宁市第一人民医院于2016年8月～2018年8月间收治的糖尿病足溃疡患者54例,依据数表法将患者随机分为对照组(n=27)和观察组(n=27)。对照组采用常规基础治疗,观察组在对照组基础上序贯使用自体富血小板凝胶联合冷沉淀制剂治疗。比较两组疗效、溃疡愈合时间、住院时间,比较两组患者治疗前及治疗20d后的肉芽组织中碱性成纤维细胞生长因子(bFGF)和血管内皮细胞生长因子(VEGF)表达水平以及糖尿病患者生存质量特异性量表评分。结果:观察组总有效率高于对照组(P0.05)。观察组溃疡愈合时间和住院时间均明显短于对照组,差异有统计学意义(P0.05)。治疗20d后,两组患者肉芽组织bFGF、VEGF表达水平均明显升高(P0.05),且观察组肉芽组织bFGF、VEGF表达水平均明显高于对照组(P0.05)。治疗20d后,两组患者生理功能、社会关系、心理或精神以及治疗影响四个维度评分均明显下降(P0.05),且观察组低于对照组(P0.05)。结论:自体富血小板凝胶联合冷沉淀制剂治疗糖尿病足溃疡疗效确切,可提高患者生活质量,可促进肉芽组织中血管生成和创面愈合。

Effects of Autologous Platelet Rich Gel Combined with Cold Precipitating Agents on Wound Healing, Angiogenic Factors and Quality of Life in Patients with Diabetic Foot Ulcers

ABSTRACT Objective: To investigate the effects of autologous platelet rich gel combined with cold precipitating agents on wound healing, angiogenic factors and quality of life in patients with diabetic foot ulcers. Methods: 54 patients with diabetic foot ulcer who were treated in The First People''s Hospital of Xining from August 2016 to August 2018 were selected, they were divided into control group (n=27) and observation group (n=27) according to random number table method. The control group was treated with routine basic treatment, while the observation group was treated with autologous platelet rich gel combined with cold precipitating agents on the basis of the control group. The curative effect, ulcer healing time and hospitalization time were compared between the two groups. The expression levels of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) in granulation tissue, and the quality of life specific scale scores of diabetic patients before treatment and 20 days after treatment were compared between the two groups. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05). The average ulcer healing time and hospitalization time in the observation group were significantly shorter than those in the control group, the difference was statistically significant (P<0.05). 20 days after treatment, the expression levels of bFGF and VEGF in granulation tissue of the two groups were significantly increased (P<0.05). The expression levels of bFGF and VEGF in granulation tissue were significantly higher in the observation group than those in the control group (P<0.05). 20 days after treatment, the scores of physiological function, social relationship, psychological or spiritual factors and treatment impact in the two groups were significantly decreased (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). Conclusion: Autologous platelet rich gel combined with cold precipitating agents is effective in treating diabetic foot ulcers, which can promote angiogenesis and wound healing in granulation tissue, it can improve the quality of life of patients.