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神经缺血性糖尿病足溃疡的光生物调节疗法:一种挽救肢体的新方法。

Photobiomodulation therapy in neuroischaemic diabetic foot ulcers: a novel method of limb salvage.

作者信息

Maiya Arun G, Kumar A Sampath, Hazari Animesh, Jadhav Radhika, Ramachandra L, Hande H Manjunatha, Rajgopal Shenoy K, Maiya Shubha G, Kalkura Prabath, Keni Laxmikant G

机构信息

Professor and Associate Dean, Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Scholar, Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

J Wound Care. 2018 Dec 2;27(12):837-842. doi: 10.12968/jowc.2018.27.12.837.

Abstract

OBJECTIVE

Low-level laser therapy (also known as photobiomodulation therapy, PBMT) promotes accelerated healing of diabetic foot ulcers (DFUs), thereby preventing the risk of future complications and amputation. The aim of this study was to determine the effect of PBMT, with structured, graded mobilisation and foot care, on DFU healing dynamics.

METHOD

Patients diagnosed with type 2 diabetes, diabetic peripheral neuropathy and presenting with a chronic neuroischaemic DFU, were treated with PBMT using scanning and non-contact probe methods. The DFU was clinically observed and the area measured every seven days until complete healing. Neuropathic parameters were also measured. The PBMT was administered until complete closure of the DFU and patients also undertook a programme of graded mobilisation.

RESULTS

A total of 17 participants were recruited, with a mean age of 69±8 years, and a mean duration of diabetes of 13±5 years. Mean complete closure time was 26±11days. In addition, a mean reduction of the semi-quantitative vibration pressure threshold from 49±2 volts to 20±4 volts was observed in all participants.

CONCLUSION

PBMT can be effectively used as a treatment mode for neuroischaemic DFUs in patients with type 2 diabetes. Graded mobilisation with focused foot care could improve the function of people living with type 2 diabetes with a chronic DFU.

摘要

目的

低强度激光治疗(也称为光生物调节疗法,PBMT)可促进糖尿病足溃疡(DFU)加速愈合,从而预防未来并发症和截肢风险。本研究的目的是确定PBMT联合结构化、分级活动及足部护理对DFU愈合动态的影响。

方法

对诊断为2型糖尿病、糖尿病周围神经病变并伴有慢性神经缺血性DFU的患者,采用扫描和非接触探头方法进行PBMT治疗。临床观察DFU情况,每七天测量一次面积直至完全愈合。同时也测量神经病变参数。持续进行PBMT直至DFU完全闭合,患者还需进行分级活动计划。

结果

共招募了17名参与者,平均年龄为69±8岁,平均糖尿病病程为13±5年。平均完全闭合时间为26±11天。此外,所有参与者的半定量振动压力阈值平均从49±2伏降至20±4伏。

结论

PBMT可有效用作2型糖尿病患者神经缺血性DFU的治疗方式。分级活动并重点进行足部护理可改善患有慢性DFU的2型糖尿病患者的功能。

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