持续负压密封引流与普通换药治疗骨科手术切口感染的临床疗效分析  

Clinical efficacies of continuous vacuum sealing drainage and commondressing in treatment of surgical incision infections in department of orthopedics

作　　者：赵晓峰[1,2] 张军[1,2] 钱宇[1,2] 

机构地区：[1]绍兴市人民医院 [2]浙江大学绍兴医院骨科,浙江绍兴312000

出　　处：《中华医院感染学杂志》2014年第2期453-455,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(y2110653)

摘　　要：目的观察持续负压密封引流(VSD)与普通清创换药在治疗骨科手术切口感染的临床疗效,比较两种方法的优缺点,为临床治疗提供参考。方法收集2011年3月-2013年4月骨科手术切口感染患者共41例,采用随机分组,其中采用VSD治疗的患者(VSD治疗组)21例,采用普通清创换药的患者(普通换药组)20例;通过记录感染切口的清洁时间、愈合时间、切口愈合分级、感染的并发症、疼痛评分及患者满意度,比较VSD与普通换药的疗效。结果 VSD组切口清洁时间为(5±1)d,切口愈合时间为(10±1)d,普通换药组分别为(8±2)d、(14±2)d,两组比较差异有统计学意义(P<0.01);切口愈合分级VSD组甲级95.6%、乙级4.4%,普通换药组甲级81.5%、乙级10.4%、丙级8.10%,两组比较差异有统计学意义(P<0.05);VSD组与普通换药组比较,感染并发症减少,差异有统计学意义(P<0.05),其中VSD治疗组有1例出现术后大量出血,为负压吸引导致血管吻合口破裂所致;VSD组术前和术后VSA疼痛评分差值为(4.86±0.67)分、满意度为(9.85±0.99)分,而普通换药组分别为(2.24±0.77)、(7.21±1.24)分,两组比较差异有统计学意义(P<0.05)。结论持续负压密封引流在骨科手术切口感染与普通换药相比,可减轻患者的痛苦、缩短愈合时间、降低切口感染的并发症、提高患者的满意度。OBJECTIVE To observe the clinical efficacies of the continuous vacuum sealing drainage （VSD） and common debridement and dressing in the treatment of surgical incision infections in department of orthopedics and find out the advantages and disadvantages of the two methods so as to provide guidance for the clinical treatment. METHODS Totally 41 cases of incision infections who underwent surgery in the department of orthopedics from Mar 2011 to Apr 2013 were enrolled in the study and were randomly grouped; the VSD group with 21 cases was treated with VSD, while the common dressing group with 20 cases was given the common debridement and dress- ing, then the time of debridement of surgical incision, incision healing time, incision healing grade, incidence of in- fective complications, score of pain, and patients＇ satisfaction were recorded, and the clinical efficacy of the VSD was compared with the common dressing. RESULTS The time of debridement of incision was （5 ± 1） days in the VSD group, （8±2）days in the common dressing group; the incision healing time was （10± 1）days in the VSD group, （14±2）days in the common dressing group, the differences between the two groups were statistically sig- nificant（P〈0.01）. There were 95.6% of the subjects with the incision healing grade A in the VSD group and 81.5% in the common dressing group; there were 4.4% of the subjects with the incision healing grade B in the VSD group and 10.4% in the common dressing group; there were 8.10% of the subjects with the incision healing grade C in the common dressing group, the differences between the two groups were statistically significant（P〈 0.05）. The incidence of the infective complications was lower in the VSD group than in the common dressinggroup, with statistical difference（P〈0.05）, there was 1 case of postoperative massive hemorrhage in the VSD group, which was caused by crack of vascular anastomosis due to vacuum suction. The difference value of the pre- operative and postoperative VSA pa

关 键 词：持续负压引流 切口感染 普通换药 骨科 

分 类 号：R619.3[医药卫生—外科学]