负压引流对褥疮合并骨感染治疗的临床效果  

Clinical effect of negative pressure drainage for treatment of bedsore with bone infections

作　　者：周宇[1] 李根卡[1] 李海[2] 

机构地区：[1]柳州市人民医院骨科,广西柳州545006 [2]上海交通大学医学院附属仁济医院骨科,上海200127

出　　处：《中华医院感染学杂志》2014年第16期4069-4070,4080,共3页Chinese Journal of Nosocomiology

基　　金：高等学校博士学科点专项科研基金资助项目(20090073120037)

摘　　要：目的探讨针对褥疮合并骨感染创面修复患者使用负压引流治疗的临床效果以及应用价值,为临床资料提供参考依据。方法选取2009年4月-2013年6月褥疮合并骨感染创面修复患者40例,随机分为普通组和治疗组,各20例,普通组在手术清创之后实施Ⅰ期皮瓣转移修复创面,治疗组在手术清创之后首先使用负压封闭引流装置治疗,其后在Ⅱ期试试皮瓣转移修复创面手术;对比两组治疗效果。结果普通组患者中有13例在Ⅰ期愈合愈合率65.00%,7例患者出现皮瓣下窦道,其中2例患者采取保守换药治疗后痊愈,5例患者再次实施了手术后痊愈;治疗组患者Ⅱ期创面手术前全部生长出肉芽且生长良好,将大部分外露骨质覆盖住,且创面无明显分泌物,呈现清洁状态,在实施皮瓣转移修复后所有患者为Ⅰ期愈合,愈合率100.00%;治疗组患者细菌量明显少于普通组,差异有统计学意义(P<0.05)。结论针对褥疮合并骨感染创面修复患者使用负压引流治疗临床效果显著确切,值得推广应用。OBJECTIVE To explore the clinical effect and application value of negative pressure drainage for the treatment of bedsore with bone infections in patients receiving wound repair so as to provide reference for clinical data.METHODS Totally 40 patients undergoing wound repair who had bedsore with bone infection from Apr.2009 to Jun.2013 were selected and randomly divided into the common group and the treatment group（n=20 in each group）,the common group received stageⅠ flap repair of the wound after debridement,the treatment group received post-debridement vacuum sealing drainage followed by stageⅡ trail flap to repair the wound.The therapeutic effects were compared between the two groups.RESULTS Totally 13 patients in the common group had their wounds healed at stageⅠ,the healing rate was 65%,7cases experienced flap fistula,2patients were cured after conservative dressing treatment,5patients were cured after re-operation.All patients in the treatment group had well granulation before stageⅡ wound operation,most of the exposed bone was covered by the granulation and no obvious secretion appeared,indicating a clean state.All patients in the treatment group had the wound healed at stageⅠ after transfer of skin flap,with the healing rate of 100%.The patients in the treatment group had significantly less bacteria than the common group（P0.05）.CONCLUSION Negative pressure drainage for treatment of bedsore with bone infections has significant and clear clinical effect,which is worthy of popularization and application.

关 键 词：负压封闭引流 褥疮 骨感染 皮瓣 氧及臭氧 

分 类 号：R181.32[医药卫生—流行病学]