两种方法对预防手部烧伤患者应用VSD装置失用的效果比较  

Comparison of two methods on prevention of VSD device apraxia for hand burn patients

作　　者：李莉[1,2] 赵宇辉[1] 曹志红[1] 刘建宇[3] 张学兵[1] 于晓牧[1] 

机构地区：[1]唐山市工人医院,河北唐山063000 [2]河北联合大学,河北唐山063009 [3]河北省唐山市丰润区人民医院,河北唐山064099

出　　处：《现代预防医学》2014年第3期564-566,共3页Modern Preventive Medicine

基　　金：河北省医学适用技术跟踪项目(GL2012-77)

摘　　要：目的 探讨应用VSD技术治疗手部烧伤创面中持续冲洗和间断灌洗两种不同处理方法对预防VSD装置失用的效果比较。方法 选择2009年2月-2012年2月我院收治的手部烧伤患者80例，随机分成观察组和对照组，每组40例。两组患者均使用相同手术方法及VSD技术治疗。观察组在术后安装VSD装置并接通负压后给予生理盐水接一次性输液器持续冲洗引流，按每日500 ml冲洗量调节滴速，72 h后改为间断冲洗，每日2次。对照组每日4次用注射器抽取生理盐水在各个三通连接处反复挤压灌洗，72 h后改为每日2次。全部VSD装置使用时间平均为7～10 d，负压源统一为医院中心负压。在术后7 d内对2组患者VSD装置使用情况进行比较。结果 观察组在术后7 d内共发生VSD装置使用不良事件9例，对照组发生32例，两组比较差异有统计学意义（P＜0.05）；观察组术后VSD装置使用寿命高于对照组，装置更换率低于对照组，两组差异有统计学意义（P＜0.01，P＜0.05）。结论 应用VSD技术治疗手部烧伤创面患者中采用持续冲洗引流法对降低VSD装置使用不良事件的效果优于间断灌洗法，可降低不良事件的发生率，提高VSD装置的有效性，值得临床推广应用。Objective To explore the application of VSD techniques that continue washing and intermittent lavage in the treatment of burn wound on preventing VSD device apraxia. Methods 80 cases of hand burn in our hospital from February 2009 - February 2012, were randomly divided into observation group and control group, 40 cases in each group. All patients all used the same operation method and VSD technique in the treatment, in observation group, postoperatively VSD was mounted, connected with negative pressure and given continuous irrigation arid drainage of saline with disposable infusion set, adjusted the drip rate according to the 500ml flush volume, after 72 hours given intermittent flushing, 2 times a day. In control group, extrusion lavage was given 4 times daily with physiological salin, after 72 hours, 2 times a day. The average time of using VSD device was 7-10 days, the negative pressure source unified hospital central vacuum. On the 7th day postoperatively, VSD device was compared in two groups. Results The adverse events of VSD device were found in 9 cases in observation group, 32 cases in control group, there was a significant dif- ference between two groups （P〈0.05）; The service life of VSD device was longer in the observation group than that of the control group, device replacement rate was lower than that of the control group, the difference between the two groups was statistically sig- nificant （P〈0.01, P〈0.05）. Conclusion Application of VSD technique using continuous flushing drainage in treatment of hand burn patients method in lowering the adverse events of VSD device is more effective than intermittent irrigation, it could reduce the incidence of adverse events, improve the VSD device effect, it is worthy of clinical application.

关 键 词：手部烧伤 VSD装置失用 预防和处理 

分 类 号：R644[医药卫生—外科学]