真空负压引流技术联合游离植皮治疗骶尾部压疮的效果观察  

Effect observation of vacuum sealing drainage combining with free skin graft in the treatment of pressure sore in sacrococcygeal region

作　　者：王焱[1] 李公[1] 潘恒[1] 韩聚川[1] 

机构地区：[1]首都医科大学附属丰台教学医院南院骨科,北京100070

出　　处：《中国当代医药》2013年第30期64-66,共3页China Modern Medicine

摘　　要：目的评价真空负压引流技术联合游离植皮治疗骶尾部压疮的效果。方法对32例骶尾部压疮患者应用真空负压引流装置进行创面准备和游离植皮的全程治疗,并于治疗前、植皮前、术后1周、术后2周、术后1个月及术后3个月对患者的全身营养状况包括上臂肌围(MAC)、腓肠肌围(CC)、血红蛋白(Hb)、白蛋白(Alb)四项指标进行评价,同时对创面局部情况(包括创面面积和细菌培养)进行监测。结果治疗前创面感染率为90.6%,应用真空负压引流技术,植皮前创面感染率为12.5%(P<0.01)。在植皮术后1周,创面面积从治疗前的(58.16±26.75)cm缩小至(8.15±3.02)cm(P<0.01)。治疗前,所有患者的MAC、CC、Hb、Alb四项指标均提示营养不良,MAC、CC在创面愈合的情况下明显改善(组内分析P<0.01);Hb、Alb在植皮手术后,有明显的提高(组内分析P<0.01)。C反应蛋白(CRP)、白细胞计数(WBC)和创面细菌培养三项指标在应用真空负压引流技术进行创面植皮准备阶段即明显降低(P<0.01)。结论真空负压引流技术联合游离植皮治疗方法能有效缩短骶尾部压疮的愈合时间,改善患者的全身营养状态,特别适合于一般情况较差的患者。Objective To evaluate the effects of vacuum sealing drainage （VSD） combining with free skin graft in the treatment of pressure sore in sacrococcygeal region. Methods 32 patients with pressure sore in sacrococcygeal region were performed on the whole course for wound preparation and free skin graft by VSD device.The nutritional status of patient＇s body including 4 indicators like arm muscle circumference （AMC）,calf circumference （CC）,hemoglobin （Hb）, and albumin （Alb） were evaluated before treatment, before skin graft,1 week,2 weeks, 1 month,and 3 months after surgery.Meanwhile,the local conditions of wound surface like wound area and bacterial cuhure were monitored. Results Before treatment,the wound infection rate was 90.6%.After adopting VSD,the wound infection rate was 12.5% before skin graft （P〈0.01）.I week after skin graft,the wound area （58.16±26.75） cm before treatment was reduced to （8.15± 3.02） cm （P〈0.01）.Before therapy,the four indicators of AMC,CC,Hb,and Alb in participants all demonstrated malnutrition.By intrablock analysis,the AMC and CC would be improved under the conditions of wound healing （P〈0.01）,and the Hb and Alb could be greatly improved after skin graft （P〈0.01）.The other 3 indicators including c-reaetive protein （CRP）,white blood cell count （WBC） and bacterial culture from wound surface all displayed that they were significantly reduced at the preparation siage of skin graft in wound surface by VSD （P〈0.01）. Conclusion The therapy of VSD combining with free skin graft can effectively shorten the healing time of pressure sore in the sacrococcygeal region, and better the nutritional status of the whole body,especially for patient with poor general condition.

关 键 词：负压封闭引流 植皮术 压疮 骶骨 营养不良 

分 类 号：R758[医药卫生—皮肤病学与性病学]