创伤负压封闭引流技术在断肢再植术中的应用

发布时间：2018-11-02 17:37

【摘要】：目的:通过探讨影响断肢再植成活率、优良率的因素及创伤负压封闭引流技术(VSD)在四肢完全毁伤离断伤断肢再植术后治疗中的应用效果的临床观察和研究,为临床治疗断肢再植及提高断肢再植成活率、优良率提供一定的参考依据。方法:统计2008年11月—2014年7月在泰安市中心医院、泰山医学院附属医院、解放军八十八医院、泰安市中医医院行四肢完全毁损离断伤断肢再植术的患者。选择其中患者40例,随机分为两组,一组为治疗组,一组为对照组,每组患者各20例,治疗组、对照组在断肢再植术后按照临床治疗标准进行常规性药物治疗,治疗组在常规性药物治疗基础上加用创伤负压封闭引流装置治疗,运用相关软件,进行回顾性分析,并观察创伤负压封闭引流技术在断肢再植术后的治疗效果。结果:对治疗组、对照组患者经过7个月至1年半年回访后,其中治疗组上肢断肢再植术10例,下肢断肢再植术10例,上肢断肢成活9例,下肢断肢成活8例,未成活行截肢术上肢1例,下肢2例,断肢成活率85%,对照组上肢断肢再植术10例,下肢断肢再植术10例,上肢断肢成活7例,下肢断肢成活7例,未成活行截肢术上肢3例,下肢3例,断肢成活率70%。按照疗效评价分析结果可知,治疗组的总优良率为85%,对照组的总优良率为70%。治疗组成活率、总优良率明显高于对照组。结论:四肢断肢再植术中应用创伤负压封闭引流技术可提高肢体离断伤再植的成活率和肢体功能的优良率。
[Abstract]:Objective: to investigate the factors influencing the survival rate and the excellent rate of amputated limb replantation, and the clinical observation and study on the effect of (VSD) in the treatment of limb replantation after complete limb injury and severed limb replantation. For clinical treatment of amputated limb replantation and improve the survival rate of amputated limb replantation, the excellent and good rate provides a certain reference. Methods: from November 2008 to July 2014, the patients with limb replantation in Taian Central Hospital, affiliated Hospital of Taishan Medical College, 88 Hospital of PLA and Tai'an Hospital of traditional Chinese Medicine were collected. Forty patients were randomly divided into two groups: the treatment group and the control group, 20 patients in each group. The treatment group and the control group were treated with conventional medicine according to the clinical treatment standard after replantation of severed limbs. The treatment group was treated with wound negative pressure sealing drainage device on the basis of routine drug therapy. The treatment effect of wound negative pressure sealing drainage technique after severed limb replantation was analyzed retrospectively by using related software. Results: in the treatment group, the patients in the control group were visited back for 7 months to 1 year. There were 10 cases of upper limb replantation, 10 cases of lower extremity severed limb replantation, 9 cases of upper limb severed limb survival and 8 cases of lower limb severed limb replantation in the treatment group. Amputation was performed in 1 case, lower extremity in 2 cases, survival rate of amputated limb in 85 cases. In the control group, 10 cases were replantation of upper limb, 10 cases were replantation of lower limb, 7 cases were amputation of upper limb, 7 cases of amputation of lower extremity, and 7 cases of amputation of lower extremity. Amputation was performed in 3 cases and lower extremity in 3 cases, and the survival rate of amputation was 70%. According to the results of curative effect evaluation, the total excellent and good rate of the treatment group was 855.The total excellent and good rate of the control group was 70. The survival rate and total excellent and good rate in the treatment group were significantly higher than those in the control group. Conclusion: the application of wound negative pressure sealing drainage in limb replantation can improve the survival rate of limb replantation and the excellent and good rate of limb function.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R658.1

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