VSD联合臭氧水治疗骨科感染性创面的临床研究  

Clinical study on the VSD combined with ozone water in the treatment of orthopaedic infectious wounds

作　　者：张仲传 朱勋兵[1] 徐洋洋 牛国旗[1] 韩冠生[1] 耿春辉[1] 韩俊柱[1] 袁伶俐[1] ZHANG Zhong-chuan;ZHU Xun-bing;XU Yang-yang;NIU Guo-qi;HAN Guan-sheng;GENG Chun-hui;HAN Jun-zhu;YUAN Ling-li(Department of Orthopaedics,The Second Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233040;Department of Orthopaedics,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第二附属医院骨科,安徽蚌埠233040 [2]蚌埠医学院第一附属医院骨科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2020年第8期1044-1047,共4页Journal of Bengbu Medical College

基　　金：蚌埠医学院自然科学研究资助项目(BYKY18151)。

摘　　要：目的:探究负压封闭引流术(VSD)联合臭氧水治疗骨科感染性创面的临床效果。方法:选取感染性创面病人40例,并按照随机数字表法分为观察组和对照组,各20例。观察组予以VSD联合臭氧水冲洗治疗,对照组予以常规VSD治疗,比较2组病人术后7 d创面愈合情况、肉芽组织菌落计数、细菌感染情况,创面渗液白细胞介素(IL-1)、肿瘤坏死因子(TNF-α)以及血管内皮生长因子(VEGF)表达水平,比较2组治疗结局。结果:观察组病人术后7 d创面愈合面积、细菌清除率均大于对照组,肉芽组织菌落计数明显低于对照组(P<0.01);与术前相比,2组病人术后7 d创面IL-1及TNF-α水平明显降低,VEGF标记指数明显提高(P<0.01),且观察组病人创面IL-1及TNF-α水平均明显低于对照组(P<0.05和P<0.01);观察组病人术后创面愈合时间明显短于对照组(P<0.01)。观察组总有效率为95.00%,对照组为70.00%,但差异无统计学意义(P>0.05)。结论:VSD联合臭氧水冲洗治疗骨科感染性创面,可有效减小细菌菌落计数,促进创面愈合,降低病人再次感染风险。Objective:To explore the clinical effects of vacuum sealing drainage(VSD)combined with ozone water in the treatment of orthopedic infectious wounds.Methods:Forty patients with infection wound were divided into the observation group and control group according to the random number table.The observation group was treated with VSD combined with ozone water,while the control group was treated with the conventional VSD.The wound healing,granulation tissue colony count between two groups were compared after 7 d of operation.The treatment outcome was compared between two groups.Results:The wound healing area and bacteria clearance rate in observation group were higher than those in control group on the seventh day after operation,and the colony count of granulation tissue in observation group was significantly lower than that in control group(P<0.01).Compared with the preoperative level,the levels of inter interleukin 1(IL-1)and tumor necrosis factorα(TNF-α)in the wound surface of two groups significantly reduced,the vascular endothelial growth factor labeling index significantly increased(P<0.01),and the levels of IL-1 and TNF-αin the wound surface of the observation group were significantly lower than those of the control group(P<0.05 and P<0.01).The healing time of the wound surface in observation group was significantly shorter than that in control group(P<0.01).The total effective rates in the observation group and control group were 95.00%and 70.00%,respectively,and the difference of which was not statistically significant(P>0.05).Conclusions:VSD combined with ozone water in treating orthopedic infectious wounds can effectively reduce the bacterial colony count,promote wound healing,and reduce the risk of infection.

关 键 词：负压封闭引流 臭氧水 骨科感染性创面 细菌清除率 愈合面积 

分 类 号：R47[医药卫生—护理学]