Clinical Experience On Local High Concentration Oxygen Treatment Of Diabetic Foot

Objective: Diabetesmellitus(DM)is a group of metabolic disease caused by insufficient insulin secretion(defects)or decreased insulin sensitivity characterized by chronic hyperglycemia.Diabetes is a serious disease that can develop from lack of insulin production in the body or due to the inability of the body’s insulin to perform its normal everyday functions.The incidence of the disease currently increased year by year.In recent years,diabetes has become the world’s third largest disease that seriously threat human’s health and life,following tumor and cardiovascular disease.Diabetic foot disease,also known as diabetes acromegaly necrosis,is one of the main complications of diabetes.Diabetics often merged with various degrees of peripheral vascular disease and neuropathy,that leads to foot and lower extremity infection,ulcer and / or deep tissue destruction.At present,diabetic foot has caused serious medical burden to society and family: It is reported that about 60% of non-traumatic leg amputation is caused by diabetic foot;At the same time,the risk of amputation will increase accordingly;Diabetic foot ulcers last for a long time,and it is estimated that the average healing time is about 6 months.About 60% of the patients need to stay in the hospital,and the patient’s mortality rate reached 39%-68% within 5 years.To search a simple,demonstrative treatment method,the present study establishes a simple,stable and portable device for the treatment of high concentration oxygen in bed,to explore the clinical application value of local high concentration oxygen therapy in the treatment of Wagner grade 1--3 in patients with diabetic foot.Methods: Subjects investigated in the study are 50 in-patients of Integrated traditional Chinese and Western Medicine ward in Dalian Medical University Affiliated Second Hospital during Mar,2014 – Oct,2015,who are clearly diagnosed as diabetes with foot disease Wagner grade 1-3 level.In our hospital,the patients are treated with developed local oxygen supply device,closed in the leg and foot,given device within a constant oxygen of 15 mmHg pressure.Among the 50 cases of patients,the shortest treatment period is 14 days,while the longest period is 28 days,the average treatment time is 21 days.Routine disinfection and sterile gauze cover of the wound is given.Every treatment last for 4 weeks,every day for 4 hours.The area change of before and after the treatment,the wound healing,skin around the device for transcutaneous oxygen points pressure changes of the toe and the changes of blood oxygen saturation,score,and give statistical analysis.The study compares wound healing area changes before and after the treatment,the skin transcutaneous oxygen points pressure around the device,changes of the toe blood oxygen saturation,evaluates the score,and gives statistical analysis.Results: 1.For all of the patients,no abnormal changes were found about blood routine,blood coagulation index,urine,stool routine,liver function,renal function,before and after treatment.2.The oxygen partial pressure(TcPo2)monitored after treatment was significantly improved than before treatment,with statistical significance(P < 0.05).The symptoms of patients were significantly improved compared with before treatment,with statistical significance(P < 0.05).Clinically,5 cases were cured,accounting for 10%;30 cases were markedly effective,accounting for 60%;12 cases were effective,accounting for 24%;3 cases were ineffective,accounting for 6%;the overall effective cases were 47,accounting for 94.00%.Conclusion: in this experiment,the local high pressure oxygen therapy were adopted.The device is simple,easy to carry,and can be applied at home when discharged.Experimental results show good therapeutic effect and it can effectively improve the local skin and wound oxygen content and prevent the formation of ulcer,thus promote ulcer healing.This study found that after 4 weeks of high concentration oxygen therapy,the wound healing degree,the oxygen saturation of the toe and the transcutaneous oxygen branch pressure were consistent.Wound area continues to shrik after local high concentration oxygen treatment of 4 weeks after most of the samples in the wound was effective.The wound area was reduced continuously,and most of the samples were effective after 4 weeks of partial high concentration oxygen therapy.For diabetic foot Wagner grade 1-3 patients,the use of lower limb partial high concentration oxygen therapy,has achieved the exact curative effect,is worth clinical application and promotion.