封闭负压引流术应用于口腔颌面部间隙感染的临床研究
发布时间：2018-08-22 16:42
【摘要】：目的:通过比较封闭负压引流(vaccum sealing drainage,VSD)与常规切开引流于颌面部间隙感染(maxillofacial space infection,MSI)治疗中患者的疼痛程度、治疗时间、抗生素使用时间、换药次数及好转率等来评估VSD的临床疗效。方法:收集大连医科大学附属第一医院口腔科病房自2015年2月至2017年1月期间住院的MSI患者30例,其中感染部位位于口底多间隙的患者23例、位于颌下间隙的患者3例、位于咬肌间隙的患者2例以及位于颊间隙的患者2例。将这些患者随机分为对照组和实验组,其中对照组20例患者行传统的切开引流术治疗,实验组10例患者采用VSD治疗。30例MSI患者入院后除了要进行常规的检查及检验来排除手术禁忌症之外,均先经验性应用抗生素行抗炎治疗并取脓汁做细菌培养加药敏试验,当检验的结果出来之后给予敏感抗生素治疗,两组患者均已穿刺并抽出脓液,满足切开引流指征并行口外切口的脓肿切开局部清创手术治疗。所有实验数据均采用SPSS 20.0统计软件进行统计分析,根据数据的特点进行T检验和卡方检验,统计资料以表格的形式进行描述分析。通过比较患者的疼痛程度、治疗时间、抗生素使用时间、换药次数及好转率等来评估VSD的临床疗效。结果:1、两组患者治疗过程疼痛情况对比,对照组治疗之前的疼痛程度值为(6.500±0.512),实验组治疗之前的疼痛程度值为(6.800±0.632),两组比较差异无统计学意义(P=0.1063)。对照组治疗过程中的疼痛程度值为(5.500±0.607),实验组治疗过程中的疼痛程度值为(3.500±0.527),两组比较差异具有统计学意义(P＜0.001),对照组治疗之后的疼痛程度值为(1.350±0.671),实验组治疗之后的疼痛程度值为(0.500±0.527),两组比较差异具有统计学意义(P=0.0005)。2、两组患者治疗时间、抗生素使用时间、换药次数及好转率对比,对照组平均治疗时间为(11.850±2.207)天,实验组平均治疗时间为(9.700±2.406)天,两组比较差异具有统计学意义(P=0.0150)。对照组抗生素平均使用天数(8.650±2.033)天,实验组抗生素平均使用天数(6.800±1.687)天,两组比较差异具有统计学意义(P=0.0076),对照组换药次数为(9.200±2.262)次,实验组换药次数为(3.900±0.738)次,两组比较差异具有统计学意义(P＜0.001)。对照组好转率为50%,实验组好转率为70%,两组比较差异无统计学意义(P=0.242)。结论:1、VSD与传统切开引流方法在治疗MSI的疗效上相比较其创口愈合时间相对较短、患者疼痛减轻、住院日降低,并且医生工作量明显减轻。2、VSD是治疗MSI的一种较好的治疗手段,可推广使用。
[Abstract]:Objective: to evaluate the clinical efficacy of VSD by comparing the pain degree, time of treatment, time of antibiotic use, times of dressing change and the rate of improvement in the treatment of (maxillofacial space infection in maxillofacial space by comparing the treatment of (vaccum sealing drainage with closed negative pressure drainage (vaccum sealing drainage) and conventional incision and drainage. Methods: from February 2015 to January 2017, 30 patients with MSI in the Department of Stomatology of the first affiliated Hospital of Dalian Medical University were collected. Two patients were located in the masseter space and two in the buccal space. These patients were randomly divided into two groups: the control group and the experimental group, in which 20 patients in the control group were treated with traditional incision and drainage. In the experimental group, 10 patients were treated with VSD. 30 patients with MSI were treated with antibiotics after admission to hospital. In addition to routine examination and test to eliminate contraindications, antibiotics were first used for anti-inflammatory therapy and pus was taken for bacterial culture and drug sensitivity test. When the results of the test were treated with sensitive antibiotics, the patients in both groups had been punctured and extracted the pus, which satisfied the indication of incision and drainage and local debridement of the abscess with external incision. All the experimental data are analyzed by SPSS 20.0 statistical software, T test and chi-square test are carried out according to the characteristics of the data, and the statistical data are described and analyzed in the form of tables. The clinical efficacy of VSD was evaluated by comparing the degree of pain, the time of treatment, the time of antibiotic use, the times of dressing change and the rate of improvement. Results the pain level of the two groups was (6.500 卤0.512) before treatment and (6.800 卤0.632) before treatment in the experimental group. There was no significant difference between the two groups (P0. 1063). The pain degree of the control group was (5.500 卤0.607), and that of the experimental group was (3.500 卤0.527). The difference between the two groups was statistically significant (P < 0.001). After treatment, the pain degree of the control group was (1.350 卤0.671), and that of the experimental group was (1.350 卤0.671). The degree of pain in the two groups was (0.500 卤0.527), the difference was statistically significant (P0. 0005). The average treatment time of the control group was (11.850 卤2.207) days, the average treatment time of the experimental group was (9.700 卤2.406) days, the difference between the two groups was statistically significant (P0.0150). The average days of antibiotic use were (8.650 卤2.033) days in the control group and (6.800 卤1.687) days in the experimental group. The difference between the two groups was statistically significant (P0. 0076). The number of changes of antibiotics in the control group was (9.200 卤2.262) times, and that in the experimental group was (3.900 卤0.738) times. The difference between the two groups was statistically significant (P < 0.001). The improvement rate of the control group was 50 and that of the experimental group was 70. There was no significant difference between the two groups (P0. 242). Conclusion compared with the traditional incision and drainage method, the wound healing time is relatively short, the pain is alleviated, the hospitalization days are reduced, and the workload of the doctor is obviously reduced. It is a better treatment method to treat MSI. It can be popularized.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.3
，
本文编号：2197709
[Abstract]:Objective: to evaluate the clinical efficacy of VSD by comparing the pain degree, time of treatment, time of antibiotic use, times of dressing change and the rate of improvement in the treatment of (maxillofacial space infection in maxillofacial space by comparing the treatment of (vaccum sealing drainage with closed negative pressure drainage (vaccum sealing drainage) and conventional incision and drainage. Methods: from February 2015 to January 2017, 30 patients with MSI in the Department of Stomatology of the first affiliated Hospital of Dalian Medical University were collected. Two patients were located in the masseter space and two in the buccal space. These patients were randomly divided into two groups: the control group and the experimental group, in which 20 patients in the control group were treated with traditional incision and drainage. In the experimental group, 10 patients were treated with VSD. 30 patients with MSI were treated with antibiotics after admission to hospital. In addition to routine examination and test to eliminate contraindications, antibiotics were first used for anti-inflammatory therapy and pus was taken for bacterial culture and drug sensitivity test. When the results of the test were treated with sensitive antibiotics, the patients in both groups had been punctured and extracted the pus, which satisfied the indication of incision and drainage and local debridement of the abscess with external incision. All the experimental data are analyzed by SPSS 20.0 statistical software, T test and chi-square test are carried out according to the characteristics of the data, and the statistical data are described and analyzed in the form of tables. The clinical efficacy of VSD was evaluated by comparing the degree of pain, the time of treatment, the time of antibiotic use, the times of dressing change and the rate of improvement. Results the pain level of the two groups was (6.500 卤0.512) before treatment and (6.800 卤0.632) before treatment in the experimental group. There was no significant difference between the two groups (P0. 1063). The pain degree of the control group was (5.500 卤0.607), and that of the experimental group was (3.500 卤0.527). The difference between the two groups was statistically significant (P < 0.001). After treatment, the pain degree of the control group was (1.350 卤0.671), and that of the experimental group was (1.350 卤0.671). The degree of pain in the two groups was (0.500 卤0.527), the difference was statistically significant (P0. 0005). The average treatment time of the control group was (11.850 卤2.207) days, the average treatment time of the experimental group was (9.700 卤2.406) days, the difference between the two groups was statistically significant (P0.0150). The average days of antibiotic use were (8.650 卤2.033) days in the control group and (6.800 卤1.687) days in the experimental group. The difference between the two groups was statistically significant (P0. 0076). The number of changes of antibiotics in the control group was (9.200 卤2.262) times, and that in the experimental group was (3.900 卤0.738) times. The difference between the two groups was statistically significant (P < 0.001). The improvement rate of the control group was 50 and that of the experimental group was 70. There was no significant difference between the two groups (P0. 242). Conclusion compared with the traditional incision and drainage method, the wound healing time is relatively short, the pain is alleviated, the hospitalization days are reduced, and the workload of the doctor is obviously reduced. It is a better treatment method to treat MSI. It can be popularized.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.3
，
本文编号：2197709
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