[摘要]目的:观察局部氧疗辅助治疗下肢慢性创面愈合的临床疗效。方法:2004年4月～2009年11月,50例下肢慢性创面不愈合患者,随机分成常规治疗组(A组)和常规治疗加局部氧疗组(B组)。A组30个患者42个创面,给予常规治疗;B组20个患者30个创面,在常规治疗的基础上每天局部氧疗1次,持续90min,每周治疗5天,4周一疗程。比较两组创面愈合所需的时间,创面愈合百分率,治疗有效率,并作统计学分析。结果:A组创面愈合时间分别为(25.3±7.6)天,B组为(18.2±5.8)天;A组创面愈合百分率为(71.8±12.1)%,B组(96.1±5.6)%; A组创面治疗有效率为71.4%,B组为100%;所有对比项目在两组之间的差异均有统计学意义(P, 百拇医药
 Topical oxygen therapy enhances closure of clinically presented chronic wounds at the lower extremity

 NIE Kai-yu1,LI Peng-cheng2, ZENG Xue-qin1, QI Jian-ping1, WANG Da-li1, WANG Yu-ming1

 (1. Department of Plastic Surgery, Affiliated First Hospital, Zunyi Medical College. Zunyi 563003,Guizhou,China; 2. Organ Transplantation Center, 309th Hospital of Chinese PLA, Beijing 100091,China)

 Abstract:ObjectiveTo observe the effect of topical oxygen therapy on chronic wounds at the lower extremity as adjunctive treatment. Methods From April 2004 to November 2009, fifty patients with chronic wounds were enrolled and divided into two groups randomly. Thirty patients with 42 chronic wounds were treated routinely, the other twenty patients with 30 chronic wounds were treated with routine methods and topical oxygen therapy. Topical oxygen therapy was administered to the wound for 90 minutes per day for 5 consecutive days in a week followed by two days of no oxygen supplementation. This cycle has been repeated for 4 week. The standard of curative effect was defined as the wound healing time, the wound healing rate and the therapic effective rate. The changes of chronic wounds between two groups were compared according to the standard.Results Comparing the clinical curative effects of two groups. The wound healing time in group A and group B was (25.3±7.6) days, (18.2±5.8)days respectively; the wound healing rate in group A and group B was (71.8±12.1)%, (96.1±5.6)% respectively, the therapic effective rate of the group Awas 71.4%, the therapic effective rate of the group B was 100%. All assessed results existedsignificant difference between two groups(P, 百拇医药
 Key words: chronic wounds;topical oxygen therapy;wound healing

 下肢创伤后,由于自身循环等多方面原因,发生延期愈合几率明显大于头部和躯干。目前, 对下肢创面的常规治疗主要是彻底清创、手术消除创面、合理使用抗生素等。慢性不愈合创面处于局部缺氧的状态[1-5],研究发现氧对于创面愈合有重要作用[1-9],围手术期补充氧可以改善创面愈合,减少术后感染,缩短住院时间[6-8]。矫正创面的缺氧状态还有助于各种生长因子发挥作用,促进慢性创面愈合[9]。动物实验及临床报道显示创面局部给氧可以提高创面局部的氧分压,有利于加速创面愈合[10-11]。我科自2004年4月～2009年11月,对下肢慢性创面(溃疡)患者,在常规治疗的基础上加用局部氧疗,收到良好疗效,现报道如下。

 1 资料和方法

 1.1 一般资料
, 百拇医药
 1.1.1 病例纳入标准:①年龄30～60岁;②创面位于下肢,超过4周未愈合;③ 未使用免疫抑制剂及抗凝治疗;④所有患者知情同意。排除标准:①曾经使用氧治疗者(包括吸入氧及高压氧治疗);②伴有骨组织病变以及干性坏疽者;③有严重心肺肾并发症者。

 1.1.2 2004年4月～2009年11月,共50例下肢慢性创面患者符合入选标准,随机分成常规治疗组(A组)和常规治疗加局部氧疗组(B组)。A组30个患者42个创面,男性20例,女性10例,平均年龄(45.6±11.6)岁,创面最大为9.5cm×10.3cm×1cm,最小3.5cm×2.5cm×0.7cm,不愈合时间是4～6 周,创伤感染18例、压迫性溃疡2例、静脉性溃疡4例、糖尿病溃疡6例;B组20个患者30个创面,男性12例,女性8例,平均年龄(44.8±15.8)岁,创面最大10cm×8.8cm×1.2cm,最小4cm×2.6cm×0.9cm,不愈合时间是4～6 周,创伤感染11例、压迫性溃疡1例、静脉性溃疡4例、糖尿病溃疡4例。, http://www.100md.com(聂开瑜 李鹏程 曾雪琴 祁建平 王达利 王玉明) 第 1 2 3 页 下一页
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