高压氧对糖尿病足溃疡患者创面愈合、生活质量及负性情绪的影响
| 作者: |
1蒋丽艳,
1周苏键,
1刘文玉
1 解放军福州总医院第二住院部康复医学科，福州 350025 |
| 通讯: |
蒋丽艳
Email: fzkfk@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.01.019 |
| 基金: | 福建省自然科学基金(09J01186)。 |
摘要
目的：观察高压氧对糖尿病足溃疡患者创面愈合、生活质量及负性情绪的影响。方法：前瞻性纳入2016年1月至2017年5月慢性糖尿病足溃疡患者60例，按照随机数字表法分为高压氧组与对照组，每组30例。对照组接受常规换药处理和护理干预，高压氧组在常规换药处理和护理干预基础上，联合高压氧治疗(升压20 min，0.2 MPa稳压65 min，其中吸氧60 min，减压20 min，共105 min；每天1次，10 d 1个疗程；连续2个疗程后，休息7~10 d，再进行第3~4个疗程；共计4个疗程)。干预前与干预4个疗程后，采用Wagner分级法评估2组创面严重程度情况，采用简明健康状况调查问卷量表(36-Item Short-Form Health Survey，SF-36)评估2组生活质量状况，采用汉密尔顿焦虑量表(Hamilton Anxiety Scale，HAMA)评估2组焦虑状况。结果：高压氧组均顺利完成4个疗程干预治疗，未见高压氧相关并发症。干预后，高压氧组创面严重程度Wagner分级较对照组显著减轻(高压氧组I，II，III，IV级分别为2，5，10，3例，对照组I，II，III，IV级分别为2，10，13，5例，χ2=9.701，P=0.021)，SF-36量表中生理职能(66.5±10.7 vs 57.8±8.9，t=3.424，P=0.001)、躯体疼痛(60.8±8.7 vs 55.6±4.9，t=2.852，P=0.006)和情感职能(72.8±6.5 vs 68.9±5.6，t=2.490，P=0.016)评分较对照组显著改善，HAMA焦虑量表评分较对照组显著降低(7.6±3.4 vs 11.2±5.5，t=3.049，P=0.003)。结论：高压氧治疗可有效促进糖尿病足患者溃疡创面愈合，改善患者生活质量并减轻其焦虑症状。
关键词：
高压氧；糖尿病足；足溃疡；生活质量；焦虑
Effect of hyperbaric oxygen on wound healing, quality of life and negative emotion in patients with diabetic foot ulcers
CorrespondingAuthor: JIANG Liyan Email: fzkfk@qq.com
DOI: 10.3978/j.issn.2095-6959.2018.01.019
Foundation: This work was supported by Fujian Provincial Natural Science Foundation, China (09J01186).
Abstract
Objective: To observe the effect of hyperbaric oxygen (HBO) on wound healing, quality of life and negative emotion in patients with diabetic foot ulcers (DFUs). Methods: From January 2016 to May 2017, 60 patients with chronic DFUs were prospectively divided into the HBO group and the control group according to the random number table, 30 cases in each group. The control group received conventional treatment and nursing intervention. The HBO group was given HBO treatment. A period of compression is in air for 20 min, followed by a treatment period at 0.2 MPa for 65 min which contains oxygen uptake 60 min, and then a decompression period of 20 min. Each session of HBO treatment lasted 105 min. One times a day, 10 days for a course of treatment. After two consecutive treatment courses, the patient rested for 7–10 days, and then the 3–4 course of treatment were given. A total of 4 treatment courses were taken. On the basis of conventional treatment and nursing intervention, the wound severity was assessed by Wagner classification method. The quality of life was assessed using the concise Health Questionnaire (SF-36). The Hamilton anxiety scale (HAMA) was used to assess the anxiety status. Results: The HBO group completed four courses of intervention successfully, and no HBO related complications were found. After the intervention, the Wagner grade of wound severity was reduced in the HBO group compared with the control group (the I, II, III, IV were 2, 5, 10, 3 cases in the HBO group, and 2, 10, 13, 5 respectively in the control group, χ2=9.701, P=0.021). The role limitation due to physical health scale (66.5±10.7 vs 57.8±8.9, t=3.424, P=0.001), the bodily pain (60.8±8.7 vs 55.6±4.9, t=2.852, P=0.006) and the role limitation due to mental health (72.8±6.5 vs 68.9±5.6, t=2.490, P=0.016) of SF-36 were significantly improved in the HBO group. The HAMA anxiety scale score was lower in the HBO group (7.6±3.4 vs 11.2±5.5, t=3.049, P=0.003).
Conclusion: HBO therapy can effectively promote wound healing, improve the quality of life and relieve anxiety symptoms in DFUs patients.
Keywords：
hyperbaric oxygen; diabetic foot; foot ulcer; quality of life; anxiety
Conclusion: HBO therapy can effectively promote wound healing, improve the quality of life and relieve anxiety symptoms in DFUs patients.