抗生素骨水泥地塞米松棕榈酸酯治疗糖尿病足溃疡△

Antibiotic-loaded bone cement combined with dexamethasone palmitate for diabetic foot ulcer

摘要:

[目的]探究抗生素骨水泥(antibiotic-loaded bone cement, ABC)联合小剂量地塞米松棕榈酸酯(dexamethasone pal- mitate, DXP)治疗糖尿病足溃疡(diabetic foot ulcer, DFU)的有效性。[方法]2020 年 11 月—2022 年 5 月，将 36 例 DFU 患者随机分为 DXP 组和盐水组。DXP 组在应用 ABC 术后 3、6、9 d 在创面局部注射小剂量 DXP，而盐水组局部注射等量的 0.9% NaCL 生理盐水，两组进行对照。[结果]DXP 组住院时间、创面愈合时间、创面愈合率均显著优于盐水组(P＜0.05)。随时间推移两组 VAS 显著降低(P＜0.05)，治疗第 9，15 d 时此评分 DXP 组显著优于盐水组(P＜0.05)。随时间推移，两组创面细菌培养阳性率均显著下降(P＜0.05)，相应时间点两组间细菌培养阳性率的差异均无统计学意义(P＞0.05)。与治疗前相比，治疗 15 d 两组 TNF-α 和 IL-6 均显著下降(P＞0.05)。治疗后 15 d， DXP 组的 TNF-α 和 IL-6 显著低于盐水组(P＜0.05)。[结论] ABC 联合小剂量 DXP 用于治疗 DFU 可以有效促进创面恢复，提高治愈率。

Abstract:

[Objective] To evaluate the efficacy of antibiotic-loaded bone cement (ABC) combined with low-dose dexamethasone palmi- tate (DXP) for diabetic foot ulcer (DFU) . [Methods] From November 2020 to May 2022, 36 patients with DFU were randomly divided into the DXP group and the saline group. After debridement and ABC application, the DXP group was injected low-dose DXP locally at 3, 6 and 9 days, while the saline group received normal saline injection locally. The clinical data were compared between the two groups. [Results] The DXP group proved significantly superior to the saline group in terms of hospital stay, wound healing time and wound healing rate (P＜ 0.05) . The VAS for pain significantly decreased over time in both groups (P＜0.05) , which in the DXP group was significantly better than the saline group at 9 and 15 days after treatment (P＜0.05) . With regard to laboratory test, the positive rate of wound bacterial culture decreased significantly in both groups over time (P＜0.05) , without a significant difference in the positive rate between the two groups at any correspond- ing time points (P＞0.05) . Compared with those before treatment, the TNF-α and IL-6 significantly decreased in both groups 15 days after treatment (P＜0.05) , which in the DXP group proved significantly lower than the saline group at 15 days after treatment (P＜0.05) . [Conclusion] ABC combined with low-dose DXP does effectively promote wound healing for diabetic foot ulcer.