负压封闭引流联合游离植皮对深度烧伤感染创面的疗效研究

发布时间：2018-02-28 12:47

本文关键词： 负压封闭引流游离植皮深度烧伤感染　出处：《中华医院感染学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨负压封闭引流联合游离植皮对深度烧伤感染创面的疗效,为临床提高治愈率提供依据。方法选取医院烧伤科就诊的深度烧伤感染患者112例,分为对照组和研究组,每组各56例,对照组给予常规的游离植皮,研究组给予负压封闭引流联合游离植皮,比较两组患者的创面愈合时间、上皮组织完全覆盖创面时间、住院时间、疼痛评分、10d愈合率、病原菌感染情况、并发症发生率以及植皮成活效果。结果研究组患者的创面愈合时间低于对照组,研究组10d创面愈合率高于对照组,差异有统计学意义(P0.05);研究组患者的上皮组织完全覆盖创面时间、住院时间均显著短于对照组,研究组疼痛评分低于对照组,差异均有统计学意义(P0.05);治疗前,对照组共培养出病原菌72株,研究组共培养出病原菌75例,均以革兰阴性菌为主,主要包括鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌;革兰阳性菌主要包括表皮葡萄球菌和金黄色葡萄球菌;治疗后,对照组感染率为16.1%(9/56),研究组感染率为1.8%(1/56),两组比较差异有统计学意义(P0.05);治疗后,对照组病原菌以鲍氏不动杆菌和大肠埃希菌为主,研究组感染的病原菌为鲍氏不动杆菌;研究组患者治疗期间的并发症发生率低于对照组,差异有统计学意义(P0.05);研究组患者的植皮成活总有效率和效果优的比例显著高于对照组,差异有统计学意义(P0.05)。结论将负压封闭引流联合游离植皮应用于深度烧伤感染创面的治疗可以有效促进创面愈合、提升总体疗效,降低患者感染,减少并发症和提升植皮成活率。
[Abstract]:Objective to investigate the effect of negative pressure sealing drainage combined with free skin grafting on deep burn infected wounds, and to provide the basis for clinical improvement of cure rate. Methods 112 patients with deep burn infection were selected and divided into control group and study group. 56 cases in each group were given routine free skin graft in control group, and the patients in study group were given negative pressure closed drainage combined with free skin graft. The wound healing time, the time of complete covering of the wound and the time of hospitalization were compared between the two groups. Results the healing time of the patients in the study group was lower than that in the control group, and the wound healing rate in the study group was higher than that in the control group. The difference was statistically significant (P 0.05), the time of covering the wound completely and the hospitalization time of the patients in the study group were significantly shorter than those in the control group, and the pain score in the study group was lower than that in the control group, and the difference was statistically significant (P 0.05); before treatment, the pain score of the study group was lower than the control group. 72 strains of pathogens were cultured in the control group and 75 cases were cultured in the study group. The main pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli. Gram-positive bacteria mainly included Staphylococcus epidermidis and Staphylococcus aureus. After treatment, the infection rate in the control group was 16.110 / 56.The infection rate in the study group was 1.810 / 56. The difference between the two groups was statistically significant (P 0.05). Acinetobacter baumannii and Escherichia coli were the main pathogens in the control group, Acinetobacter baumannii was the main pathogen in the study group, and the incidence of complications in the study group was lower than that in the control group. The difference was statistically significant (P 0.05), the proportion of total effective rate and excellent effect of skin grafting in the study group was significantly higher than that in the control group. Conclusion the application of negative pressure sealing drainage combined with free skin grafting in the treatment of deep burn infection wounds can effectively promote wound healing, improve the overall efficacy, reduce the infection of patients, reduce complications and increase the survival rate of skin grafts.
【作者单位】：台州市第一人民医院烧伤外科;台州市第一人民医院检验科;
【基金】：浙江省卫生厅医药科技计划资助项目(20152922)
【分类号】：R644

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