扩创植皮联合封闭负压引流技术在大面积烧伤患者感染难愈创面治疗的效果

发布时间：2018-03-10 00:04

本文选题：烧伤　切入点：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】：目的探讨扩创植皮联合封闭负压引流技术在大面积烧伤患者感染难愈创面治疗的效果,为临床治疗提供依据。方法选取2011年6月-2016年6月医院收治的大面积烧伤感染难愈创面患者62例,根据收治时间不同将患者分为观察者与对照组,各31例,给予对照组扩创植皮治疗,观察组给予扩创植皮治疗基础上联合封闭负压引流治疗,对两组治疗总有效率、植皮成活率、创面愈合率及并发症发生率等进行比较。结果观察组与对照组治疗总有效率分别为90.3%、67.7%,观察组与对照组相比其治疗总有效率明显提高,差异有统计学意义(P0.05);观察组与对照组术后第3天植皮成活率分别为80.6%、38.7%,两组间比较差异有统计学意义(P0.05);观察组与对照组患者术后第6天创面愈合率分别为87.1%、35.5%,两组间比较差异有统计学意义(P0.05);观察组平均住院时间为(37.9±7.5)d,对照组平均住院时间为(45.7±14.3)d,观察组与对照组相比明显缩短,差异有统计学意义(P0.05);与对照组比较,观察组术后前三次换药时的VAS疼痛评分均明显降低,差异有统计学意义(P0.05);在并发症发生率方面,观察组3.2%与对照组16.1%比较明显降低,差异有统计学意义(P0.05);在治疗满意度方面,观察组治疗总满意度为93.5%,与对照组治疗总满意度74.2%相比明显升高,差异有统计学意义(P0.05)。结论对大面积烧伤感染难愈创面患者给予扩创植皮联合封闭负压引流治疗具有良好的治疗效果,可提高植皮成功率及创面愈合率,并降低并发症发生率,值得临床进一步推广应用。
[Abstract]:Objective to investigate the effect of skin grafting combined with sealing negative pressure drainage in treating the infected and refractory wounds in large area burn patients. Methods from June 2011 to June 2016, 62 patients with severe burn infection were divided into two groups: observer and control group (31 cases each). The patients in the control group were treated with skin grafting, and the patients in the observation group were treated with combined treatment with negative pressure drainage. The total effective rate and survival rate of skin graft in the two groups were determined. Results the total effective rate of treatment in the observation group and the control group was 90.3 and 67.7respectively. The total effective rate of the observation group was significantly higher than that of the control group. The survival rate of skin grafts in the observation group and the control group on the 3rd day after operation was 80.6 and 38.7, respectively, and the difference between the two groups was statistically significant (P 0.05), and the wound healing rate of the observation group and the control group on the 6th day after operation was 87.1% or 35.5%, respectively. The average hospitalization time in the observation group was 37.9 卤7.5 days, and the average hospitalization time in the control group was 45.7 卤14.3 days, which was significantly shorter than that in the control group. Compared with the control group, the VAS pain score of the observation group decreased significantly in the first three times after the operation, and the difference was statistically significant (P 0.05), and the incidence of complications in the observation group 3.2% was significantly lower than that in the control group (16.1%). In terms of treatment satisfaction, the total treatment satisfaction in the observation group was 93.5, which was significantly higher than that in the control group (74.2%). Conclusion there is a good therapeutic effect for patients with large area burn infection and refractory wound by skin grafting combined with negative pressure drainage, which can improve the success rate of skin grafting and wound healing rate, and reduce the incidence of complications. It is worthy of further clinical application.
【作者单位】：杭州市江干区人民医院烧伤科;吉林市中心医院烧伤科;
【基金】：浙江省医学会临床科研基金资助项目(2011zyc-B04)
【分类号】：R644

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