Clinical Study Of Vacuum Sealing Drainage Combined With Hyperbaric Oxygen Therapy On Diabetic Foot In High Altitude Area

Objective: To investigate the effect of vacuum sealing drainage(VSD)combined with hyperbaric oxygen therapy(HBOT)on diabetic foot in high altitude area.Methods: From September 2016 to October 2018,60 patients with diagnosed diabetic foot(Class II~IV)were enrolled,including 28 males and 32 females.According to the random number table,30 patients in the experimental group and 30 patients in the control group were included.The control group on the basis of conventional treatment(controlled diet,control blood sugar and anti-infection),the wound was treated with VSD.The vacuum value was-80~-60 mm Hg(1 mm Hg=0.133 k Pa),continuous vacuum sealing,and replaced once every 7 days for 2 times.The experimental group was in control.On the basis of in control group,combined with HBOT for treatment,placed in a multi-person hyperbaric oxygen chamber with a pressure of 0.20-0.25 MPa.The pressure-regulating mask absorbs pure oxygen for 90 min,intermittently for 2 times,each section lasts for 30 min,and rests for 10 min,1 time./d,a total of 14 times.The changes of blood gas analysis were observed before treatment and after treatment for 7 days,14 days;Peripheral oxygen partial pressure was measured by percutaneous oxygen partial pressure test;Changes in the levels of epidermal growth factor(EGF),vascular endothelial growth factor(VEGF)and platelet derived growth factor(PDGF)were measured by enzyme-linked immunosorbent assay;observed changes in wound area and calculated wound healing rate.Data were analyzed by t test,?2 test and oneway ANOVA to compare the efficacy of the two.Results: The two groups of general data were compared before treatment,and the difference was not statistically significant(P > 0.05),which was comparable.After 7 days and 14 days of treatment: 1 blood gas analysis was compared,the arterial oxygen partial pressure oxygen,blood oxygen saturation and blood oxygen content of the experimental group were significantly improved,while the control group showed no significant change,the difference was statistically significant(P < 0.05).2 The oxygen partial pressure of the wound tissue was compared,and the oxygen partial pressure of both groups increased,while the increase of the experimental group was higher than that of the control group,the difference was statistically significant(P <0.05).3 The contents of EGF,VEGF and PDGF in wound tissue were compared,and the two groups were increased,while the increase in the experimental group was more significant(P <0.05).4 Wound healing rate was compared,the wound healing rate of both groups increased,and the experimental group was significantly higher than the control group,the difference was statistically significant(P <0.05).Conclusions: 1.VSD combined with HBOT is better than VSD alone;2.VSD combined with HBOT can improve the oxygen partial pressure of wounds,improve the ischemia and hypoxia of wounds,increase the expression level of growth factors,improve the microcirculation and granulation tissue proliferation,improve the wound healing rate and accelerate the healing of wounds.