糖尿病足溃疡的危险因素探讨及亲水性纤维含银敷料促进患者伤口愈合的临床对照研究

摘要 目的：探讨糖尿病足溃疡（DFU）的危险因素，并研究亲水性纤维含银敷料促进患者伤口愈合的应用价值。方法：选取2017年8月-2020年12月期间我院收治的糖尿病患者230例。230例糖尿病患者中发生DFU的79例，纳为DFU组，剩余151例未发生DFU，纳为无DFU组。DFU组的患者采用随机数字表法分为治疗1组39例和治疗2组40例，治疗1组给予传统纱布敷料，治疗2组给予亲水性纤维含银敷料。采用多因素Logistic回归分析DFU发生的危险因素。观察治疗1组、治疗2组的临床疗效和临床指标。结果：DFU组、无DFU组在性别、年龄、户籍地、糖尿病病程、并发下肢血管病变、并发周围神经病变、足底有胼胝、血红蛋白（Hb）、C反应蛋白（CRP）、白蛋白（ALB）、总胆固醇（TC）、纤维蛋白原（FIB）、红细胞沉降率（ESR）、高密度脂蛋白（HDL）、 胱抑C（CysC）、 低密度脂蛋白（LDL）、脂蛋白aLp(a)]、糖化血红蛋白（HbAlc）方面对比差异有统计学意义（P<0.05）。男性、糖尿病病程、并发下肢血管病变、并发周围神经病变、足底有胼胝、ALB、ESR、CysC、CRP、Lp(a)、HbAlc均是DFU发生的危险因素（P<0.05）。治疗2组的临床总有效率明显高于治疗1组（P<0.05）。治疗2组的创面愈合时间、出现明显肉芽时间、住院时间短于治疗1组，住院费用高于治疗1组（P<0.05）。结论：DFU的发生受到多种因素影响，包括男性、糖尿病病程、并发下肢血管病变等，因此临床应加强对这些因素的预防和控制。此外，亲水性纤维含银敷料可促进DFU患者创面愈合，疗效显著。

Explore of Risk Factors for Diabetic Foot Ulcers and Clinical Control Study of Hydrophilic Fiber Containing Silver Dressing for Promote Wound Healing of Patients

ABSTRACT Objective: To explore the risk factors of diabetic foot ulcers (DFU), and to study the application value of hydrophilic fiber containing silver dressing to promote wound healing of patients. Methods: 230 cases of diabetes mellitus patients who were admitted to our hospital from August 2017 to December 2020 were selected. Of the 230 cases of diabetes mellitus patients, 79 cases had DFU occurrence, seted as DFU group, and the remaining 151 cases had no DFU occurrence, seted as no DFU group. Patients in DFU group were randomly divided into treatment group 1 and treatment group 2 by random number table method. Treatment group 1 was given traditional gauze dressing, and treatment group 2 was given hydrophilic fiber containing silver dressing. Multivariate Logistic regression was used to analyze the risk factors of DFU occurrence. The clinical efficacy and clinical indexes of treatment group 1 and treatment group 2 were observed. Results: There were significant differences in gender, age, registered residence, diabetes course, concurrent lower limb vascular disease, concurrent peripheral neuropathy, with plantar callus, hemoglobin (Hb), C reactive protein (CRP), albumin (ALB), total cholesterol (TC), fibrinogen (FIB), erythrocyte sedimentation rate (ESR), high-density lipoprotein(HDL), cystine C(CysC), low density lipoprotein (LDL), lipoprotein a Lp(a)] and glycosylated hemoglobin (HbAlc) in group DFU and no group DFU (P<0.05). Male, diabetes course, concurrent lower limb vascular disease, concurrent peripheral neuropathy, with plantar callus, ALB, ESR, CysC, CRP, Lp(a) and HbAlc were all risk factors for DFU occurrence(P<0.05). The total clinical effective rate of treatment group 2 was significantly higher than that of treatment group 1(P<0.05). The wound healing time, obvious granulation time and hospitalization time of treatment group 2 were shorter than those of treatment group 1, and the hospitalization cost was higher than that of treatment group 1(P<0.05). Conclusion: The DFU occurrence is influenced by many factors, including male, diabetes course, concurrent lower limb vascular disease, etc. Therefore, the prevention and control of these factors should be strengthened in clinical practice. In addition, hydrophilic fiber containing silver dressing can promote wound healing in DFU patients.