VSD技术在小腿慢性感染性创面中的临床运用  

Clinical Application of Vacuum Sealing Drainage in the Treatment of Chronic Leg Ulcers

作　　者：宋政 李爱民 金竹炫 赵利民 Song Zheng;Li Aimin;Jin Zhuxuan;Zhao Limin(Department of Cardiothoracic Surgery,The First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China;Department of General Surgery,The First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China;Department of Orthopaedics and Thoracic Surgery,Weishan County People′s Hospital,Weishan,Yunnan 672400,China)

机构地区：[1]大理大学第一附属医院胸心外科,云南大理671000 [2]大理大学第一附属医院普外二科,云南大理671000 [3]巍山县人民医院骨科胸外科,云南巍山672400

出　　处：《大理大学学报》2021年第4期44-47,共4页Journal of Dali University

摘　　要：目的:分析负压封闭引流(VSD)技术治疗小腿慢性感染性创面的临床疗效,为临床应用提供治疗依据。方法:收集巍山县人民医院收治的50例小腿慢性感染性创面患者,根据治疗类型分为对照组和观察组,每组25例;对照组予外科清创后换药处理,观察组在外科清创后行VSD治疗。比较两组患者的营养状况、疼痛评分、创面二期缝合准备时间、住院天数、住院总费用、出院后换药次数及术后复发情况。结果:两组患者年龄、性别、创面部位、病史、创面面积、创面初次处理方式、抗生素使用时间等一般资料和白蛋白水平、自评-主观全面评估量表评分等营养状况资料比较,差异无统计学意义(P>0.05)。观察组在治疗后第1、3、5天疼痛程度较对照组减轻,且在第3、5天减轻明显,差异有统计学意义(P<0.05);观察组创面二期缝合准备时间、住院时间、出院后换药次数均少于对照组,差异有统计学意义(P<0.05);观察组住院总费用高于对照组,差异有统计学意义(P<0.05);出院后对照组有4例患者创面发生复发感染,观察组无复发感染病例,差异具有统计学意义(P<0.05)。结论:VSD对治疗小腿慢性感染性创面效果明显,但费用较高,应根据患者创面情况个性化应用。Objective:To analyze the clinical effect of VSD in the treatment of chronic leg ulcers so as to provide a treatment basis for clinical application.Methods:50 patients with chronic leg ulcers in Weishan County People′s Hospital were selected.They were divided into the control group and the observation group according to the type of treatment,with 25 patients in each group.The control group was treated with dressings after surgical debridement,and the observation group was treated with VSD treatment after surgical debridement.The nutritional status,the pain score,the preparation time of secondary suture,length of hospitalization,total hospitalization expenses,the number of dressing changes after discharge and postoperative recurrence were compared between the two groups.Results:There was no significant difference between the two groups in age,gender,wound site,history,wound area,initial treatment of wounds,duration of antibiotic use,albumin levels,and PG-SGA score(P>0.05).The pain degree of the observation group was less than that of the control group on the 1st,3rd and 5th day after treatment,and the difference was statistically significant on the 3rd and 5th day(P<0.05).The preparation time of secondary suture,and length of hospitalization and dressing changes after discharge in the observation group were less than those in the control group,with statistically significant differences(P<0.05).The total expenses of hospitalization in the observation group were higher than that in the control group,and the difference was statistically significant(P<0.05).After discharge,there were 4 cases of recurrent infection in the control group,and no cases of recurrent infection in the observation group,the difference was statistically significant(P<0.05).Conclusion:VSD has obvious effects in the treatment of chronic infectious wounds of the lower limbs,but the cost is high,so the application should be individualized according to the wound condition of patients.

关 键 词：慢性感染性创面 负压封闭引流技术 小腿创面 

分 类 号：R454[医药卫生—治疗学]