负压封闭引流在重症肢端缺血患者截肢术中的应用  

Application of the vacuum sealing drainage in amputation of the patient with critical limb ischemia

作　　者：龚凯[1] 黄道景[1] 张亚明[1] 范跃祖[1] 

机构地区：[1]同济大学附属同济医院血管外科,上海200065

出　　处：《现代医学》2012年第5期535-537,共3页Modern Medical Journal

摘　　要：目的:探讨负压封闭引流(VSD)技术在重症肢端缺血患者截肢术中应用的临床价值。方法:回顾性分析66例重症肢体缺血坏疽截肢术患者的临床资料。35例患者(VSD组)在离断肢体后先应用VSD技术治疗创面,7 d后再二期缝合伤口;31例患者(对照组)离断肢体后一期缝合残端伤口。观察两组患者术后伤口愈合情况、并发症、住院时间和治疗费用。结果:VSD组患者伤口愈合率为91%,感染率为0,死亡率为9%,平均住院时间为23.5 d,平均费用为14 485元;对照组患者伤口愈合率52%,感染率42%,死亡率19%,平均住院时间58.8 d,平均费用32 213元。两组上述5项比较差异均有统计学意义(均P<0.01)。结论:重症肢端缺血患者截肢术中应用VSD技术,在预防残端伤口感染、促进伤口愈合、降低死亡率、减少住院时间和费用等方面起到积极的作用,值得推广。Objective： To assess the clinical effectiveness of application of the vacuum sealing drainage（VSD） in amputation of the patient with critical limb ischemia.Methods： The data of 66 amputated patients with critical limb ischemia gangrene were reviewed retrospectively.Of 35 patients,VSD was applied to treat wound after the limb amputated,the wound was sutured secondarily after 7 days;of 31 patients,the wound closure was performed at the first stage.The wound healing conditions,the complication,the hospital time and cost were evaluated between two groups.Results： In the VSD group,the wound healing rate was 91%;the wound infection rate was 0;the mortality rate was 9%;the median length of hospital stay was 23.5 days;the median hospital cost was 14 485 yuan;in the first-stage suturing group,the wound healing rate was 52%;the wound infection rate was 42%;the mortality rate was 19%;the median length of hospital stay was 58.8 days;the median hospital cost was 32213 yuan.There was a significant difference between two groups（P0.01）.Conclusion： Application of the VSD in amputation of the patient with critical limb ischemia plays a positive role in the prevention of wound infection,promoting wound healing,reducing mortality,reducing hospital time and cost,etc,which is recommended to adopted widely.

关 键 词：负压封闭引流 截肢术 重症肢端缺血 

分 类 号：R687.5[医药卫生—骨科学]