水动力清创系统用于深Ⅱ度烧伤创面治疗临床疗效的回顾性研究  

Retrospective study on the clinical effect of hydrosurgery system in the treatment of deep partial-thickness burn wound

作　　者：王磊[1] 蔡玉辉[1] 胡克苏[1] 朱兴华[1] 张逸[1] Wang Lei;Cai Yuhui;Hu Kesu;Zhu Xinghua;Zhang Yi(Department of Burns and Plastic Surgery,Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院烧伤整形科,226001

出　　处：《中华损伤与修复杂志（电子版）》2021年第3期245-250,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：江苏省科技厅产学研合作项目(BY2020208);南通市科技局基金项目(HS2020006);南通市科技局项目(MSZ20121);南通市科技局项目(MSZ19147)。

摘　　要：目的分析水动力清创系统用于深Ⅱ度烧伤创面清创的临床疗效,为深Ⅱ度烧伤创面的治疗提供新的思路和方法。方法选取南通大学附属医院烧伤整形科2018年1月至2019年12月收治的符合入院标准的深Ⅱ度烧伤患者40例,烧伤面积为2%~29%总体表面积(TBSA),位于躯干、四肢的非关节功能部位的创面[(100±10)cm^(2)]区域为试验窗口区。按照随机数字表法将入组患者分为观察组与对照组,每组20例。所有患者在入院后均使用0.5%聚乙烯吡咯烷酮-碘消毒液作创面消毒,无菌纱布敷料包扎。观察组试验窗口区采用VERSAJETⅡ水动力清创系统进行创面清创,对照组试验窗口区采用常规手术器械进行创面清创。2组患者试验窗口区清创后创面用脂质水胶敷料覆盖,消毒纱布包扎,其余创面在试验窗口区清创结束后根据研究者判断及患者意愿选择相应清创方法。清创术后根据患者情况给予抗感染、营养补充等对症治疗,定期行创面换药直至创面愈合。观察2组患者创面坏死组织清除率,创面愈合时间,清创术后第7、14、21天创面感染情况及肝功能、肾功能、凝血象、血常规化验指标数值波动情况。对数据行t检验。结果观察组患者创面坏死组织清除率为(93.5±2.4)%,相比对照组[(91.3±3.9)%]明显提高,差异有统计学意义(t=-3.371,P<0.05);观察组患者创面愈合时间为(15.8±3.0)d,相比对照组[(18.5±3.6)d]明显缩短,差异有统计学意义(t=2.960,P<0.05);观察组患者清创术后第7天创面感染评分为(2.75±0.44)分,相比对照组[(2.55±0.51)分],差异无统计学意义(t=-1.165,P>0.05);观察组患者清创术后第14、21天创面感染评分为(1.60±0.26)、(0.80±0.19)分,相比对照组[(2.35±0.67)、(1.25±0.97)分]明显降低,差异均有统计学意义(t=4.156、3.244,P<0.05);2组患者手术清创前、后的肝功能、肾功能、凝血象、血常规等化验指标均未见明显波动。结论应Objective To analyze the clinical efficacy of hydrosurgery system in the treatment of deep partial-thickness burn wound,and to provide new ideas and methods for the treatment of deep partial-thickness burn wound. Methods From January 2018 to December 2019,40 patients with deep partial-thickness burns who met the selection criteria were selected from the Department of Burns and Plastics,Affiliated Hospital of Nantong University.The burns area was 2%-29%of the total body surface area(TBSA).The wound area located in the non joint functional parts of the trunk and limbs(100±10)cm^(2) was the experimental window area.The patients were divided into two groups according to random number table method,20 cases in each group.All patients were treated with 0.5%polyvinylpyrrolidone iodine disinfectant for wound disinfection after admission,then bandaged with sterile gauze dressing.VersajetⅡhydrodynamic debridement system was used for wound debridement in the test window area of the observation group.Conventional surgical instruments were used for wound debridement in the test window area of the control group.After debridement,the wounds of the two groups were covered with lipid water gel dressing in the test window area,bandaged with sterile gauze.After debridement in the window area of the test area,the corresponding debridement methods were selected according to the judgment of the researchers and the wishes of the patients.After debridement,symptomatic treatment such as anti-infection and nutritional supplement was given to the patients according to their conditions.Wound dressing was changed regularly until wound healing.The rate of wound necrosis tissue clearance,infection after operation,wound healing time were observed,and the wound infection,liver function,renal function,coagulation blood image and blood routine test index at 7,14,21 days after debridement were observed in the two groups.Data was processed witht test. Results The wound necrotic tissue clearance rate of the observation group was(93.5±2.4)%,which w

关 键 词：清创术 烧伤 感染 伤口愈合 水动力清创系统 

分 类 号：R655[医药卫生—外科学]