早期外用肝素联合改良封闭负压吸引技术在42例电击伤患者治疗中的疗效观察  

Observation of curative effect of early topical heparin combined with improved vacuum sealing drainage in 42 cases of electrical injury patient

作　　者：高富成[1] 薛宏斌[1] 侯国玲[1] GAO Fucheng XUE Hongbin HOU Guolin(Affiliated Hospital of Yan＇an University, Yan＇an 716000, China)

机构地区：[1]延安大学附属医院,陕西延安716000

出　　处：《临床医药实践》2017年第3期179-182,共4页Proceeding of Clinical Medicine

摘　　要：目的:观察早期外用肝素联合改良负压吸引技术在高压电击伤后治疗中的效果。方法:42例高压电击伤患者生命体征平稳后行彻底创面清创,清除焦痂及坏死组织,过氧化氢、生理盐水、碘伏彻底反复清洗创面,清创后外用肝素联合改良封闭负压吸引技术(VSD),行持续封闭负压引流,根据创面治疗情况更换敷料,待创面培养出符合手术封闭创面条件的肉芽组织,二期采用皮瓣移植或游离皮片移植封闭创面,观察术后皮瓣及皮片的成活情况。结果:23例使用1次持续封闭负压引流后,创面新鲜、肉芽组织生长良好;16例使用2次后,创面新鲜,肉芽组织丰富,二期行刃厚皮片或中厚皮片移植,皮片均存活良好;3例创面伴有骨外露,行邻位或随意皮瓣转移,皮瓣存活良好。结论:早期外用肝素联合改良负压吸引技术能改善高压电击伤患者的临床治疗效果,缩短病程,减轻患者痛苦,便于操作和护理,在治疗电击伤后皮肤及软组织缺损中有良好的临床应用前景。Objective：To observe the treatment effect of the early topical heparin combined with the improved vacuum sealing drainage in high voltage electrical injury. Methods：Forty- two cases of high voltage electrical injury patients in our department,after their vital signs were stable,they were early cleaned the surface of wounds completely,eliminated the eschar and necrotic tissue,and repeatedly cleaned wound with hydrogen peroxide solution,physiological saline and iodophor. Then we gived them topical heparin combined with the improved vacuum sealing drainage and continuous negative pressure drainage. According to the wound condition we changed dressing,when the wound cultured granulation tissue in the condition of surgical close wound. In the two stage,we used skin flap or free skin graft to seal the wound and observe the survival of skin flap and skin graft after operation. Results：The wound of 23 cases using a continuous closed negative pressure drainage was fresh,the granulation tissue grew well;the wound of 16 cases using 2 times＇ continuous closed negative pressure drainage（ changed once dressing） was fresh,the granulation tissue was rich,after thick skinned or medium thickness skin graft in the second phase,all skin grafts survived well;3 cases of wound with bone exposed,gived ortho or free flap transplant,flaps survived well. Conclusion：The treatment measures which is early topical heparin combined with the improved vacuum sealing drainage can improve clinical therapeutic effect of the high voltage electrical injury patients,shorten the course of disease,relieve the pain of the patients,ease of operation and nursing,and has good prospects for clinical application in the treatment of skin and soft tissue defect after electrical injury.

关 键 词：肝素 改良负压引流技术 电击伤 肉芽组织 

分 类 号：R62[医药卫生—整形外科]