摘要
目的:探讨负压封闭引流技术(vacuum-sealing drainage,VSD)联合冲洗技术在坏死性筋膜炎(necrotizing fasciitis,NF)治疗中的应用价值及其安全性。方法:选取本院2020年5月-2021年6月40例NF患者随机分为两组,观察组(n=20)采用VSD联合冲洗技术治疗,对照组(n=20)采用传统换药方式进行治疗。观察两组创面周围皮肤水肿情况、肉芽组织生长情况、创面渗液情况、创面及皮瓣缺血坏死情况,从而分析VSD联合冲洗技术的临床应用价值及安全性。结果:(1)手术当天两组患者皮肤水肿评分比较差异无统计学意义(u=-0.089,P>0.05)。术后第3、7天观察组评分低于对照组,差异有统计学意义(u=-3.322、-2.222,P<0.05)。(2)术后第7天观察组的肉芽组织量多,肉芽组织生长有效的例数多于对照组,差异有统计学意义(χ^(2)=9.231,P<0.05)。(3)术后第1天两组创面渗液量比较差异无统计学意义(t=1.273,P>0.05)。术后第3、7天观察组创面渗液量均少于对照组,差异有统计学意义(t=7.702、4.774,P<0.05)。(4)术后第1、3天两组患者创面周围皮瓣缺血坏死例数比较差异无统计学意义(χ^(2)=2.506、2.667,P>0.05);术后第7天观察组创面及皮瓣缺血坏死例数少于对照组(χ^(2)=4.800,P<0.05)。结论:VSD技术联合冲洗技术治疗NF能够促进水肿消退和肉芽生长,同时能够降低创面渗液量和组织缺血,临床治疗有效,其安全性相比传统换药治疗更为可靠。
Objective:To investigate the application value and safety of vacuum-sealing drainage (VSD) combined with therapeutic irrigation in the treatment of necrotizing fasciitis (NF).Method:Forty patients with NF were randomly selected in our hospital from May 2020 to June 2021 and they were divided into two groups.The patients of observation group (n=20) underwent the treatment of VSD combined therapeutic irrigation,and the patients of control group (n=20) underwent the treatment of routine method.The skin edema,wound healing,granulation tissue growth,wound exudates,tissue ischemia were observed,and the clinical value and safety of the VSD combined with therapeutic irrigation were analyzed.Result:(1) There was no significant difference in skin edema score between the two groups on the day of operation (u=-0.089,P>0.05).At the 3rd and 7th day after operation,the skin edema scores of observation group were significantly lower than those of control group,the differences were statistically significant (u=-3.322,-2.222,P<0.05).(2) On the 7th day after operation,the amount of granulation tissue in the observation group was more than that in the control group,and the number of effective cases were more than that of control group.the difference was statistically significant (χ^(2)=9.231,P<0.05).(3) There was no significant difference on the amount of wound exudates between the two groups on the 1st day after operation (t=1.273,P>0.05).At the 3rd and 7th day after operation,the amount of wound exudates in the observation group were significantly less than those in the control group (t=7.702,4.774,P<0.05).(4) At the 1st and 3rd day after operation,there were no significant differences in the number of cases of tissue ischemia between the two groups (χ^(2)=2.506,2.667,P>0.05).On the 7th day after operation,the number of cases of tissue ischemia in the observation group was significantly less than that in the control group,there was no significant difference (χ^(2)=4.800,P<0.05).Conclusion:The VSD combined with therapeutic irrigation can promote the regression of edema and the growth of granulation tissue,and can reduce the amount of wound exudates and the number of cases of tissue ischemia.Therefore,it has significant curative effect,and is safer than traditional dressing change.
作者
刘移峰
黄锦刚
高俊仕
刘平洪
林桂清
黎伙聪
高敏怡
戴娴静
LIU Yifeng;HUANG Jingang;GAO Junshi;LIU Pinghong;LIN Guiqing;LI Huocong;GAO Minyi;DAI Xianjing(Guangzhou Integrated Traditional Chinese and Western Medicine Hospital,Guangzhou 510800,China;不详)
出处
《中外医学研究》
2021年第25期54-57,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
负压封闭引流技术
冲洗技术
坏死性筋膜炎
水肿
肉芽组织
渗液
缺血
Vacuum-sealing drainage
Therapeutic irrigation
Necrotizing fasciitis
Edema
Granulation tissue
Exudates
Ischemia
