负压封闭引流技术对四肢软组织缺损感染患者的临床治疗效果研究

发布时间：2018-05-28 07:15

本文选题：负压封闭引流 + 四肢软组织缺损　；参考：《中华医院感染学杂志》2017年13期

【摘要】：目的探讨负压封闭引流技术(VSD)应用四肢软组织缺损伴感染患者的临床治疗效果和对组织局部供血的影响。方法选取在2014年2月-2016年9月医院的四肢软组织缺损感染患者的71例进行分析,随机分为常规组35例和研究组36例,两组患者均进行清创术处理后,常规组患者采取常规换药方法,而研究组患者选择负压封闭引流术作为治疗方法,对两组患者的抗感染时间、住院时间、换药次数、抗菌药物使用时间及局部供血情况比较分析,并观察在治疗1天、5天、10天患者的疼痛程度,以及比较两组患者的创面愈合时间、愈合病例,治疗有效率,并发症发生情况和不良反应发生率。结果研究组患者的感染治疗时间为(11.46±1.85)d、住院时间为(50.53±4.31)d、换药次数(1.79±0.58)次、抗菌药物使用时间(3.64±1.12)d、创口愈合时间(30.42±2.76)d,均明显少于常规组;研究组患者的局部平均血流量(46.81±9.45)mV,明显高于常规组的平均血流量(23.96±5.73)mV;疼痛程度按照SF-MPQ疼痛评分法,研究组患者在1天(5.08±0.73)分、5天(3.97±1.06)分、10天(1.23±0.89)分的疼痛评分均低于常规组;研究组治疗有效率为97.22%明显高于常规组;研究组患者的并发症发生率为2.78%、不良反应发生率为5.56%明显低于常规组,以上数据两组比较差异均有统计学意义(P0.05)。结论负压封闭引流技术在治疗四肢软组织缺损并创面感染患者时,具有更确切的疗效,能够缩短治疗和抗感染时间,加速创口愈合,对于感染的控制和临床治疗效果比传统换药治疗具有明显的优势。
[Abstract]:Objective to investigate the clinical effect of negative pressure sealing drainage (VSD) in patients with soft tissue defect and infection in extremities and its effect on local blood supply. Methods from February 2014 to September 2016, 71 patients with soft tissue defect infection in extremities were randomly divided into routine group (n = 35) and study group (n = 36). The patients in both groups were treated by debridement. The patients in the routine group were treated by routine dressing change, while the patients in the study group were treated by negative pressure blocking drainage. The time of anti-infection, the time of hospitalization, the times of dressing change were used in the two groups. The time of use of antimicrobial agents and the local blood supply were compared, and the pain degree of the patients was observed at 1 day to 5 days to 10 days, and the wound healing time, the healing cases and the effective rate of treatment were compared between the two groups. Incidence of complications and adverse reactions. Results in the study group, the time of infection treatment was 11.46 卤1.85 days, the hospitalization time was 50.53 卤4.31 days, the times of change of medicine was 1.79 卤0.58 times, the time of using antibiotics was 3.64 卤1.12 days, the wound healing time was 30.42 卤2.76 days, which was obviously less than that of the routine group. The mean local blood flow was 46.81 卤9.45mV in the study group, which was significantly higher than that in the routine group (23.96 卤5.73mV). According to the SF-MPQ pain score, the pain score of the patients in the study group was lower than that in the control group (1.23 卤0.89) on the 1st day (5.08 卤0.73) and 10 days (1.23 卤0.89). The effective rate of treatment in the study group was 97.22% higher than that in the routine group, and the incidence of complications and adverse reactions in the study group was 2.78 and 5.56% respectively, which was significantly lower than that in the routine group, and the difference between the two groups was statistically significant (P 0.05). Conclusion the technique of negative pressure sealing and drainage is more effective in the treatment of soft tissue defect and wound infection in extremities, it can shorten the time of treatment and anti-infection, and accelerate the wound healing. The control of infection and the effect of clinical treatment have obvious advantages over the traditional dressing change treatment.
【作者单位】：台州市第一人民医院骨科(温州医科大学附属黄岩医院);
【分类号】：R658

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