两种负压创面治疗技术临床疗效比较  

A comparative study of the clinical effects between two kinds of negative-pressure wound therapy

作　　者：胡恺轩[1] 章宏伟[1] 周芳[1] 姚刚[1] 史京萍[1] 王立夫[1] 侯祚琼[1] 

机构地区：[1]南京医科大学第一附属医院整形烧伤科,210029

出　　处：《中华烧伤杂志》2009年第4期253-257,共5页Chinese Journal of Burns

摘　　要：目的比较2种负压创面治疗技术（NPWT）的临床疗效、不良反应及卫生-经济成本的差异。方法选择44例急性、亚急性、慢性创面患者，按随机数字表法分为简易法组和常规法组。简易法组患者3种创面采用纱布＋医院中心负压（-10．64kPa）24h持续吸引；常规法组3种创面采用海绵＋专业负压吸引器（-16．63kPa）24h间断吸引。比较2组患者治疗前后创面大体情况、治疗时间、皮片和皮瓣移植成活率、创面菌种变化、治疗成本及不良反应发生率。结果简易法组和常规法组患者创面大体情况、治疗时间[（294±12）、（264±13）d，P〉0．05]、菌群种类、皮片移植成活率[（984±4）％、（984±4）％，P〉0．05]以及皮瓣移植成活率（98％、100％）相近。简易法组总治疗成本[（3744±134）元]明显低于常规法组[（98254±4956）元，P〈0．01]，简易法组不良反应发生率（33．3％）明显高于常规法组（5．0％，P〈0．05）。结论简易法和常规法NPWT均可有效促进创面愈合。简易法不良反应偏多，存在院内感染风险，但使用方便、成本较低；常规法需降低成本，以便推广应用。Objective To compare the differences of the clinical effects, side effects and treatment- related cost between two kinds of negative-pressure wound therapy （ NPWT）. Methods Forty-four inpatients with acute, subacute, and chronic wounds were divided into simplified NPWT group （A group） and conventional NPWT group （ B group） according to the random number table. Wounds of patients in A group were treated with gauze ＋ continuous suction with hospital central negative pressure （ - 10.64 kPa） for 24 hs; wounds of patients in B group were treated with sponge ＋ interrupted suction with a purpose-designed suction appliance （ -16.63 kPa） for 24 hs. Gross wound condition, treatment time, survival rates of skin graft and flap, changes of bacterial species on wound, treatment cost, and ratio of side effects between two groups were compared. Results There was no significant difference between A and B groups in respect of gross wound condition, treatment time [ A group （29 ± 12） d, B group （26 ± 13 ） d, P 〉 0.05 ] , changes of bacterial species, survival rates of skin graft IA group （98±4）% , B group （98±4）% ,P 〉0.05] and flap （A group 98% , B group 100% , P 〉0.05）. Treatment cost of A group ￥ （374±134） was obviously lower than that of B group￥ （9825 ±4956） （ P 〈0. 01）, while more side effects were observed in A group （33.3%） than that in B group （5.0%） （ P 〈0.05）. Conclusions Both simplified NPWT and NPWT with purpose-designed appliance can effectively improve wound healing. The simplified method may cause many side effects and has a potential risk of inciting nosocomiat infection, but it can be conveniently employed with a low cost. In contrast, the cost of using purpose-designed appliance should be cut down to meet the aim of generalization.

关 键 词：负压伤口疗法 急性创面 慢性创面 创面愈合 

分 类 号：R473.6[医药卫生—护理学]