负压封闭引流技术对重度烧伤伴全身炎症反应综合征的疗效评价  

Therapeutic effect of vacuum sealing drainage to severe burn combined with systemic inflammatory response syndrome

作　　者：苏卫国[1,2] 王平丽 魏莹[2] 周一平[1] 牛希华[2] 娄季鹤[2] 李永林[2] 

机构地区：[1]南方医科大学南方医院烧伤科,广州510515 [2]郑州市第一人民医院烧伤科,郑州450004 [3]河南医学高等专科学校外科教研室,郑州450000

出　　处：《上海交通大学学报（医学版）》2014年第2期184-188,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：郑州市技术研究与开发经费支持项目(083SGHH33297)~~

摘　　要：目的观察负压封闭引流技术对重度烧伤伴全身炎症反应综合征（SIRS）的疗效。方法将36名重度烧伤伴SIRS患者，分为治疗组（n=18）和对照组（n=18），治疗组应用负压封闭引流技术治疗创面，每5一，7d更换一次；对照组清创后应用磺胺嘧啶银混悬液外涂于创面，每日更换敷料。比较两组患者术后7d内脓毒症等并发症的发生率、平均每1％全身体表面积（TBSA）烧伤创面的住院费用以及渗出量、人血白蛋白用量和悬浮红细胞用量；分别于术前以及术后24、72、120h，比较两组患者的白细胞计数、中性粒细胞比例以及C反应蛋白（CRP）和降钙素原（PCT）的质量浓度。结果术后，治疗组较对照组并发症发生率低（P〈0．05）。治疗组的1％TBSA住院费用、悬浮红细胞用量、人血白蛋白用量和术后7d内渗出量均显著低于对照组，差异有统计学意义（P〈0．05）。与对照组比较，术后第24h起治疗组患者的白细胞计数、中性粒细胞比例以及CRP和PCT质量浓度均显著降低，差异有统计学意义（P〈0．05）。结论负压封闭引流技术是治疗重度烧伤伴SIRS的有效创面处理方法，能降低脓毒症等并发症的发生率和住院费用。Objective To observe the therapeutic effect of vacuum sealing drainage in severe burns with the systemic inflammatory response syndrome （SIRS）. Methods A total of 36 cases of severe burn combined with SIRS were divided into treatment group （n = 18） and control group （n = 18）. Vacuum sealing drainage was used for treatment group while the sulfadiazine silver was used for the control group. The incidence of complications, exudation of 1% total body surface area （TBSA）, cost of hospitalization, use of human serum albumin and red blood cell of each group were compared within 7 d after surgery. The leucocyte count, percentage of neutrophile granulocyte, C reactive protein （CRP） and procalcitonin （PCT） were compared between two groups before surgery and at 24, 72, and 120 h after surgery. Results The incidence of complications of treatment group was less than the control group after surgery （P 〈 0.05）. The cost of 1% TBSA hospitalization, consumption of red blood cell and human serum albumin, and exudation within 7 d after surgery were all significantly lower than those of control group, the difference was statistically significant （P 〈 0.05）. The leucocyte count, percentage of neutrophile granulocyte, CRP, and PCT after surgery being performed 24 h were all significantly lower than those of control group, the difference was statistically significant （P 〈 0.05）. Conclusion Vacuum sealing drainage is an efficient method to treat severe burn combined with SIRS. It can reduce the incidence rate of sepsis and other complications and cost of hospitalization.

关 键 词：重度烧伤 全身炎症反应综合征 负压封闭引流技术 

分 类 号：R644[医药卫生—外科学]