VSD治疗在胫腓骨开放性骨折感染中的应用价值研究  

Study of the value of the application of VSD in the treatment of tibial and fibula open fracture infection

作　　者：张荣灿 许志贤[1] 张正超 Zhang Rongcan;Xu Zhixian;Zhang Zhengchao(Department of Emergency Surgery,Fujian Provincial Hospital,Fuzhou,Fujian,350001,China)

机构地区：[1]福建省立医院急诊外科,福建福州350001

出　　处：《当代医学》2020年第17期6-9,共4页Contemporary Medicine

摘　　要：目的观察胫腓骨开放性骨折患者应用负压封闭引流技术(vacuum-sealing drainage,VSD)治疗后在骨折感染中的应用效果,为临床治疗骨折后感染提供有力依据。方法选取2015年2月至2016年10月于本院骨伤外科收治的腓骨开放性骨折感染患者67例进行回顾性分析,根据不同的治疗方法分为常规组和研究组,其中常规组31例患者采取常规持续灌洗,研究组36例患者以负压封闭引流术作为治疗方法,治疗6~12个月,平均9个月为观察期,对比两组患者的感染治疗时间、住院时间、治疗过程中的疼痛程度以及患者创口愈合时间、程度和治疗有效率情况。结果治疗6个月后,研究患者的感染治疗时间为(13.28±2.61)d、住院时间为(37.22±5.63)d均短于常规组(21.34±4.57)d、(56.39±8.74)d(P<0.05)。研究组VAS疼痛评分为(4.24±0.76)分,明显低于常规组的(7.93±1.08)分(P<0.05)。治疗后,两组患者的创面均有不同程度的愈合,其中研究组的愈合效果较好;研究组治疗总有效率为94.44%,明显高于常规组的83.87%,差异有统计学意义(P<0.05)。结论负压封闭引流技术在治疗胫腓骨开放性骨折患者时,能够缩短治疗时间,减轻患者痛苦,使伤口创面早期愈合,对于治疗初期预防感染和控制治疗后继发感染有明确的临床应用价值。Objective To observe the application effect of vacuum-sealing drainage(VSD)in the treatment of open fractures of tibia and fibula,and to provide a powerful basis for clinical treatment of post-fracture infection.Methods 67 patients with open fractures of fibula treated in our hospital from February 2015 to October 2016 were retrospectively analyzed and they were divided into the conventional group and the study group according to different treatment.Among them,31 patients treated with routine continuous lavage were as the conventional group,while 36 patients with negative pressure drainage were as the study group.6-12 months,and average of 9 months were as the observation period.The infection treatment time,length of stay,pain in the course of treatment and wound healing time,extent and treatment efficiency of the two groups were compared.Results After 6 months of treatment,the duration of infection treatment was(13.28±2.61)d and hospital stay was(37.22±5.63)d,had significant advantages of the control group of(21.34±4.57)d and(56.39±8.74)d(P<0.05).The VAS pain score during the treatment in the study group(4.24±0.76)was significantly lower than that in the conventional group(7.93±1.08)(P<0.05).After treatment,the wound had different degrees of healing,in which the healing effect of the study group was better.The effective rate of the study group(94.44%)was significantly higher than that in the conventional group(83.87%)(P<0.05).Conclusion Negative pressure closed drainage technique can shorten the treatment time and relieve pain in the treatment of open fracture of tibia and fibula.It can make the wounds heal early.It is of clinical value for prevention of infection and control of secondary infection after treatment.

关 键 词：VSD 胫腓骨 开放性骨折 感染 

分 类 号：R683.4[医药卫生—骨科学]