封闭负压吸引技术联合手术治疗在难愈性创面治疗上的应用

发布时间：2018-07-06 19:12

本文选题：难愈性创面 + 负压吸引　；参考：《延安大学》2017年硕士论文

【摘要】：目的:本研究主要对封闭负压吸引技术联合手术治疗在难愈性创面治疗上应用价值的研究,比较封闭式负压吸引技术联手术治疗和常规换药联合手术治疗两种治疗方法在难愈性创面治疗过程中的差异。从而为我国难愈性创面的临床治疗提供新的思路和临床依据,有助于促进我国难愈性创面治疗技术的发展,使该技术在广大的基层医院能够普及。方法:收集延安大学附属医院2014年10月至2016年12月所诊治的难愈性创面患者共40例,随机分为封闭负压吸引治疗组和常规治疗组,每组20例,记录患者性别、年龄、创面面积等一般情况,签订治疗知情同意书。负压吸引治疗组给予负压吸引治疗技术联合手术治疗,常规治疗组给予常规换药联合手术治疗。观察两组患者治疗后创面愈合时间、创面愈合率、创面感染清除时间、换药次数、住院时间、首次清创距行手术治疗时间、清创后3、7、11天VAS疼痛评分,得出相关数据,应用SPSS22.0统计软件对数据进行统计学处理。结果:1.封闭负压吸引治疗组与常规治疗组的一般情况比较封闭负压吸引治疗组男13例,女7例;常规治疗组男11例,女9例,二者在性别构成上无统计学意义(P0.05);封闭负压吸引治疗组的年龄为(52.04±7.22)岁,常规治疗组患者的年龄为(49.08±6.94)岁,二者在年龄上无统计学意义(P0.05);封闭负压吸引治疗组的创面面积为(45.52±12.34)cm2常规治疗组的创面面积为(40.93±11.64)cm2二者在创面面积上差异无统计学意义(P0.05),两组患者的一般情况符合统计学要求。2.封闭负压吸引治疗组与常规治疗组的治疗后创面愈合时间、创面感染清除时间的比较封闭负压吸引治疗组的创面愈合时间为(9.65±3.12)天,常规治疗组的创面愈合时间为(17.95±3.35)天,二者之间差异有统计学意义(p0.05);封闭负压吸引治疗组的创面感染清除时间为(8.75±2.61)天,常规治疗组的创面感染清除时间为(14.00±3.28)天,二者之间差异有统计学意义(p0.05)。3.封闭负压吸引治疗组与常规治疗组的住院时间、首次清创距手术治疗时时间、创面换药次数的比较封闭负压吸引治疗组的住院时间为(18.55±4.29)天,常规治疗组的住院时间为(31.30±6.91)天,二者之间差异有统计学意义(p0.05);封闭负压吸引治疗组的首次清创踞手术治疗时间为(7.10±2.17)天,常规治疗组的首次清创距手术治疗时间为(14.20±3.47)天,二者之间差异有统计学意义(p0.05);封闭负压吸引治疗组的换药(敷料)次数为(1.90±1.37)次,常规治疗组的换药(敷料)次数为(14.45±3.80)次,二者之间差异有统计学意义(p0.05)。4.封闭负压吸引治疗组与常规治疗组的创面愈合率的比较封闭负压吸引治疗组创面愈合率为95.00%和常规治疗组的创面愈合率为60.00%,差异有统计学意义(χ~2=3.91p=0.013)。5.封闭负压吸引治疗组与常规治疗组的清创后3、7、11天vas疼痛评分的比较.封闭负压吸引治疗组的首次清创后3天的vas疼痛评分为(4.08±1.25),常规治疗组的首次清创后3天的vas疼痛评分为(6.59±1.30),二者差异有统计学意义(p0.05);封闭负压吸引治疗组的首次清创后7天的vas疼痛评分为(3.13±0.72),常规治疗组的首次清创后7天的vas疼痛评分为(4.94±0.97),二者差异有统计学意义(p0.05);封闭负压吸引治疗组的首次清创后11天的vas疼痛评分为(1.59±0.74),常规治疗组的首次清创后11天的vas疼痛评分为(3.78±0.53),二者差异有统计学意义(p0.05)。结论:1.封闭负压吸引治疗技术能有效缩短难愈性创面患者的创面愈合时间及创面感染清除时间。2.封闭负压吸引治疗技术能明显缩短患者的住院时间,使患者能够尽早接受手术治疗,减少创面换药次数。3.封闭负压吸引治疗技术能有效提高难愈性创面患者的创面愈合率。4.封闭负压吸引治疗技术可以有效缓解难愈性创面患者术后创面的疼痛程度,减轻患者的痛苦。
[Abstract]:Objective: To study the application value of closed negative pressure suction technique combined with surgical treatment on refractory wounds, and compare the difference between two treatments in the treatment of refractory wounds with closed negative pressure suction technique combined with conventional medicine treatment and the treatment of refractory wounds. The treatment provides new ideas and clinical basis, which helps to promote the development of refractory wound treatment technology in our country and make the technology popularized in the vast grass-roots hospitals. Methods: 40 cases of refractory wounds treated in Affiliated Hospital of Yan'an University from October 2014 to December 2016 were collected, and they were randomly divided into closed negative pressure suction treatment group and usual. The treatment group, 20 cases in each group, recorded the general situation of the patient's sex, age, wound area and other general conditions, and signed the informed consent. The negative pressure attraction treatment group was treated with the combined operation of negative pressure suction therapy, the conventional treatment group was given conventional medicine and combined operation. The healing time of wound wound, wound healing rate and wound surface after treatment were observed in the two groups. The time of infection clearance, the times of change, the time of hospitalization, the time of the first debridement and the time of operation, the VAS pain score of 3,7,11 days after debridement, the relevant data were obtained, and the data were statistically processed with the SPSS22.0 software. Results: 1. the general situation of the closed negative pressure suction treatment group and the conventional treatment group was compared with the closed negative pressure suction treatment group 13 men. There were 7 cases, 11 women and 9 women in the conventional treatment group (P0.05). The age of the closed negative pressure treatment group was (52.04 + 7.22) years, the age of the conventional treatment group was (49.08 + 6.94) years old and the two in the age was not statistically significant (P0.05), and the wound area of the closed negative pressure group was 45.52 + 12. .34) the surface area of cm2 in the conventional treatment group was (40.93 + 11.64) cm2 two, and there was no significant difference in the area of wound surface (P0.05). The general conditions of the two groups were in conformity with the statistical requirements for the wound healing time after the treatment of the.2. closed negative pressure suction group and the conventional treatment group, and the comparison of the clearance time of the wound infection by closed negative pressure suction therapy The wound healing time of the group was (9.65 + 3.12) days, the wound healing time of the conventional treatment group was (17.95 + 3.35) days, the difference between the two groups was statistically significant (P0.05), the clearance time of the wound infection in the closed negative pressure suction group was (8.75 + 2.61) days, and the clearance time of the wound infection was (14 + 3.28) days in the conventional treatment group, and the difference between the two were of the two. Statistical significance (P0.05).3. closed negative pressure suction treatment group and the routine treatment group of hospital time, the first time of debridement in the treatment time, the number of wound dressing, the comparison closed negative pressure group of hospitalization time was (18.55 + 4.29) days, the routine treatment group was (31.30 + 6.91) days, the difference between the two was statistically significant ( P0.05); the treatment time of the first debridement and entrenching operation in the closed negative pressure treatment group was (7.10 + 2.17) days, the time for the first debridement of the conventional treatment group was (14.20 + 3.47) days, the difference between the two groups was statistically significant (P0.05); the change of dressing (dressing) in the closed negative pressure suction group was (1.90 + 1.37) times, and the change of the conventional treatment group (the treatment group) was changed. The number of dressings was (14.45 + 3.80) times. The difference between the two groups was statistically significant (P0.05) the wound healing rate of the closed negative pressure suction treatment group and the conventional treatment group was compared with the conventional treatment group. The wound healing rate in the closed negative pressure suction group was 95% and the wound healing rate in the conventional treatment group was 60%, the difference was statistically significant (x ~2=3.91p=0.013).5. closure. The VAS pain score of 3,7,11 days after debridement in the negative pressure treatment group and the conventional treatment group. The VAS pain score was (4.08 + 1.25) after the first debridement after the first debridement in the closed negative pressure treatment group, and the VAS pain score was (6.59 + 1.30) at 3 days after the first debridement in the routine treatment group (6.59 + 1.30), and the two difference was statistically significant (P0.05); the closed negative pressure was attracted by the treatment group (P0.05). The VAS pain score of 7 days after the first debridement in the treatment group was (3.13 + 0.72). The VAS pain score was (4.94 + 0.97) on the 7 day after the first debridement in the routine treatment group (4.94 + 0.97), and the two difference was statistically significant (P0.05); the vas pain score of the first debridement after the first debridement in the closed negative pressure group was (1.59 + 0.74), and the normal treatment group was vas after the first debridement after the first debridement. The score of the pain was (3.78 + 0.53) and the difference between the two was statistically significant (P0.05). Conclusion: 1. closed negative pressure suction therapy can effectively shorten the healing time of wound healing and the clearance time of wound infection, and.2. closed negative pressure suction therapy can significantly shorten the patient's hospitalization time and enable the patient to receive surgical treatment as soon as possible. .3. closed negative pressure suction therapy can effectively improve the wound healing rate of patients with refractory wounds,.4. closed negative pressure suction therapy can effectively alleviate the degree of pain in the wounds of the patients with refractory wounds and relieve the pain of the patients.
【学位授予单位】：延安大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R641

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