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目的评价大剂量前列腺素E1在冲击治疗糖尿病足合并动脉病变患者中的应用效果,总结其作用机制,旨在为该病临床治疗方案选择提供参考依据。方法选取该院2015年6月-2017年6月收治的糖尿病足合并动脉病变患者110例为研究对象,Wagner分级为Ⅰ~Ⅲ级(以下简述“WⅠ~Ⅲ”),采用双盲随机法分为参照组与研究组各55例,均给予前列腺素E1冲击治疗,参照组调整剂量为10 g/d(疗程2周),研究组则为40 g/d(疗程1周),经治疗后3个月随访,前瞻性分析两组患者各数据指标。结果研究组患者中WⅡ~Ⅲ级创面愈合率明显优于参照组(P<0.05);研究组与参照组截肢率差异无统计学意义(P>0.05);研究组NGF、EGF含量水平明显高于参照组(P<0.05);两组并发症发生率与截肢率差异无统计学意义(P>0.05)。结论大剂量前列腺素E1冲击治疗糖尿病足合并动脉病变患者确有较好疗效,可有效提升NGF、EGF含量水平,促进创面恢复,此外总结其优势还包括愈合率较高,且不会增加截肢率与并发症发生率,治疗安全性有所保障,具有临床应用与推广价值。
Objective To evaluate the effect of high-dose prostaglandin E1 in the treatment of patients with diabetic foot complicated by arterial disease and to summarize its mechanism of action, aiming to provide reference for clinical treatment of this disease. Methods Totally 110 patients with diabetic foot complicated with arterial disease admitted from June 2015 to June 2017 in our hospital were enrolled in this study. Wagner was graded as grade Ⅰ ~ Ⅲ (hereinafter referred to as “W Ⅰ ~ Ⅲ”), Randomly divided into the reference group and the study group of 55 patients were given prostaglandin E1 shock treatment, the reference group adjusted dose of 10 g / d (treatment for 2 weeks), the study group was 40 g / d (treatment for 1 week) After 3 months of follow-up, prospective analysis of the data of two groups of patients. Results The WⅡ ~ Ⅲ wound healing rate was significantly higher in the study group than in the reference group (P <0.05). There was no significant difference in the amputation rate between the study group and the reference group (P> 0.05). The levels of NGF and EGF in the study group were significantly higher In the reference group (P <0.05). There was no significant difference between the two groups in the incidence of complications and amputation rate (P> 0.05). Conclusion High-dose prostaglandin E1 shock treatment of diabetic foot complicated with arterial disease does have a good effect, which can effectively improve the level of NGF, EGF, and promote wound healing, in addition to summarize its advantages also include a higher healing rate, and will not increase the amputation rate And the incidence of complications, treatment safety has been protected, with clinical application and promotion of value.