封闭式负压引流术在毁损性手外伤临床治疗中的应用  

Application of vacuum sealing drainage in the clinical treatment of destroyed hand injuries

作　　者：魏优秀[1] 李贺伟[1] 周伟[1] 黄松[1] 韦卓[1] 

机构地区：[1]华中科技大学同济医学院附属梨园医院骨科,武汉430077

出　　处：《中国医师进修杂志（外科版）》2009年第10期1-3,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨封闭式负压引流术（VSD）在治疗毁损性手外伤中的应用效果。方法2006年1月至2008年12月收治毁损性手外伤患者40例（40个创面），均为手部一元或多元组织毁损缺失者。所有患者创面先行清创后，随机分为两组：VSD组20例和对照组（洗必泰湿敷）20例，并应用疼痛指数、肿胀指数、细菌检测、创面继发组织坏死指标进行评价。结果治疗后3dVSD组疼痛指数为（2．62±1．54）分，对照组疼痛指数为（3．39±1．64）分，两组比较差异有统计学意义（P〈0．01）；VSD组肿胀指数为（1．51±0．25）分，与对照组的（2．29±1．26）分比较差异有统计学意义（P〈0．05）；VSD组细菌阳性率为5％（1／20），对照组为20％（4／20），两组比较差异有统计学意义（P〈0．05）；VSD组没有发生创面继发组织坏死，对照组出现2例创面继发组织坏死，其中有1例出现严重组织坏死，采取部分坏死肢体解脱术。结论VSD可以控制感染，免除换药，减轻疼痛，刺激肉芽组织生长，为组织移植提供良好的条件。VSD联合组织移植为毁损性手外伤治疗的一种理想方法。Objective To evaluate the effect of vacuum sealing drainage （VSD） on the destroyed hand injuries. Methods From January 2006 to December 2008, forty patients with destroyed hand injuries （surface of wound ） were randomly divided into VSD group （20 cases） and control group （chlorhexidine wet compress ）（ 20 cases ） after debridement. The outcomes were retrospectively analysed by pain score,swelling score, bacterial positive rate and necrotic tissue. Results Three days after treatment, the pain score of VSD group was （2.62 ±1.54） degree, and that of control group was （3.39 ± 1.64） degree. There was significant difference between the two groups （P 〈 0.01 ）. The swelling score of VSD group was （1.51± 0.25 ） degree which was different from control group（ 2.29 ± 1.26 ） degree （P 〈 0.05 ）. The bacterial positive rate of control group was 20% （4/20）, but that of VSD group was 5% （1/20）. There was significant difference between the two groups （P〈 0.05 ）. The VSD group had no necrotic tissue oecurrence, but the control group had 2 cases, one of which had serious necrosis and had escapology. Conclusion VSD can inhibit bacterial infection, ease pain, exempt changing dressings and stimulate growing of granulation tissue also can maintain a good environment for tissue transplantation later. So VSD combining with tissue transplantation is an ideal therapy in destroyed hand injuries.

关 键 词：引流术 负压 组织移植 手外伤 

分 类 号：R658.2[医药卫生—外科学] R651.150.5[医药卫生—临床医学]