负压封闭引流减少创面毒素再损伤的临床观察  

Vacuum sealing drainage reduces wound toxins re-injury

作　　者：黎清波[1] 王欣[1] 邹艳丽[1] 龚平[1] 

机构地区：[1]武汉大学中南医院骨科,430071

出　　处：《中华创伤骨科杂志》2011年第1期47-50,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 通过与未行负压封闭引流（VSD）的创伤患者进行比较,探讨VSD减少创面愈合时毒素对机体再损伤的作用.方法 回顾性分析2005年1月至2009年6月采用VSD治疗的32例患者（VSD组）和同期未行VSD治疗的37例患者（换药组）资料.两组性别比例、年龄、损伤部位、面积、合并伤及创伤时间等一般情况比较差异均无统计学意义（P＞0.05）.比较两组患者治疗前和治疗后1周的体温、血常规、肝肾功能变化、创面治疗及愈合时间等,并对结果进行多因素线性回归分析.结果 治疗前两组患者体温、血常规及肝肾功能指标的比较差异均无统计学意义（P＞0.05）.治疗后5～7 d,VSD组与换药组的体温高于正常时间分别为（3.3±1.3）、（6.4±1.9）d,白细胞分别为（8.8±2.3）、（12.4±1.9）g/L,中性粒细胞分别为（6.3±2.4）、（9.2±2.7）g/L谷丙转氨酶分别为（41.1±30.0）、（58.9±34.5）U/L,谷草转氨酶分别为（38.0±24.7）U/L、（54.5±28.0）U/L,血肌酐分别为（94.8±23.7）、（118.6±23.5）μmol/L,伤口清创至植皮时间分别为（12.9±5.7）、（23.8±6.8）d,治疗时间分别为（26.5±12.5）、（36.7±13.2）d,创面愈合时间分别为（33.8±13.5）、（41.4±13.2）d,两组数据比较差异均有统计学意义（P＜0.05）.结合各指标多因素分析及两组数据治疗前比较结果,治疗方式的不同是引起差异的主要因素.结论 VSD能促进创面毒素排出,减少毒素的再吸收和对机体的再损伤,促进创面愈合,缩短疗程.Objective To investigate the effect of vacuum sealing drainage （VSD） on wound healing by reducing re-injury to the tissue attributable to wound toxins. Methods A series of 32 patients with serious limb trauma were included in the present study who received VSD treatment in our department from January 2005 to June 2009. Another series of 37 patients of the same category were used as controls who received no VSD treatment but dressing instead at the same period. Exclusion criteria were liver and kidney diseases, diabetes mellitus, hypertension, serious organ disorders and major nerve and vascular injuries.There were no significant differences between the 2 groups in sex, age, site and size of injury, complications,time of trauma （P〉0.05）. Body temperature and blood parameters （including results of hepatic and renal function tests） before and one week after the VSD treatment, wound management, and wound healing time were compared between the 2 groups, using multi-factor linear regression analysis. Results There were no significant differences between the 2 groups in body temperature and blood parameters （ P 〉 0. 05 ） before treatment. But there were significant differences after treatment between the 2 groups in duration of high body temperature（3.3±1.3 days for the VSD group versus 6. 4 ± 1.9 days for the control group）, white blood cells （8.8±2.3 g/L versus 12.4±1.9 g/L）, neutrophil （6.3 ±2.4 g/L versus 9.2 ±2. 7 g/L）, alanine aminotransferase （41.1±30.0 U/L versus 58.9 ±34. 5 U/L）, aspartate aminotransferase （38.0±24.7 U/L versus 54.5±28.0 U/L）, creatinine （94.8±23.7 μmol/L versus 118.6±23.5 μmol/L）, wound debridement to skin grafting time （12.9±5.7 days versus 23.8±6.8 days）, total treatment time （26.5 ± 12.5 days versus 36.7±13.2 days）, wound healing time （33.8±13.5 days versus 41.4±13.2 days） （ P 〈0. 05 =. All the analyses showed the difference were attributable to VSD treatment. Conclusion VSD can facilitate wound healing and shor

关 键 词：引流术 创伤和损伤 毒物 再损伤 

分 类 号：R473.6[医药卫生—护理学]