外科清创联合VSD治疗急性创面的效果观察  

Observation on the effect of surgical debridement combined with VSD in the treatment of acute wounds

作　　者：李邦良 刘兰 胡志华 LI Bangliang;LIU Lan;HU Zhihua(Department of Orthopedics,the First Affiliated Hospital of Jiangxi Medical College,Shangrao,Jiangxi,334000,China)

机构地区：[1]江西医学高等专科学校第一附属医院骨科,江西上饶334000

出　　处：《当代医学》2021年第29期23-25,共3页Contemporary Medicine

基　　金：江西省上饶市科技指导计划项目(20201CKJ16)。

摘　　要：目的探讨外科清创联合负压封闭引流(VSD)治疗急性创面的效果。方法选取2018年5月至2020年5月本院收治的60例急性创面患者为研究对象,按照随机数字表法分为两组,各30例。B组给予外科清创+常规换药治疗,A组在B组基础上联合VSD治疗。比较两组患者治疗情况(创面面积、住院时间、应用抗生素费用、换药次数、创面Ⅱ期手术处理时间)、炎症指标[C-反应蛋白(CRP)、白细胞计数(WBC)、中心粒细胞比值(NEU%)]及创面形态。结果A组住院时间、创面Ⅱ期手术处理时间短于B组,创面面积小于B组,应用抗生素费用低于B组,期间换药次数少于B组,差异有统计学意义(P<0.05);治疗后,两组CRP、WBC、NEU%水平低于治疗前,且A组低于B组(P<0.05);治疗后,两组肉芽生长、渗出评分均低于治疗前,且A组低于B组(P<0.05)。结论外科清创联合VSD能有效缩短急性创面患者康复时间,减少药物应用,并能改善患者血清指标,促进创面生长,值得临床推广运用。Objective To investigate the effect of surgical debridement combined with vacuum sealing drainage(VSD)in the treatment of acute wounds.Methods 60 patients with acute wounds admitted to our hospital from May 2018 to May 2020 were selected as the research subjects.They were divided into two groups by random number table method,with 30 cases in each with.Group B was treated with surgical debridement+conventional dressing change,and group A was treated with VSD on the basis of group B.The treatment status(wound area,hospital stay,antibiotics cost,number of dressing changes,treatment time of wound phase II surgery),inflammatory indicators[C-reactive protein(CRP),white blood cell count(WBC),neutrophil ratio(NEU%)]and wound morphology between two groups were compared.Results After treatment,the hospital stay and treatment time of wound phase II surgery group A were shorter than group B,the wound area was smaller than group B,antibiotics cost,number of dressing changes was lower than group B,and the times of dressing change during the period was less than group B,the difference was statistically significant(P<0.05);after treatment,the levels of CRP,WBC and NEU%in the two groups were lower than before treatment,and the group A were lower than group B(P<0.05);after treatment,the granulation growth and exudation scores of the two groups were lower than those before treatment,and group A was lower than group B(P<0.05).Conclusion Surgical debridement combined with VSD can effectively shorten the recovery time of patients with acute wounds and reduce the use of drugs.It can alleviate the inflammatory response of patients and promote the growth of wounds,which is worthy of clinical promotion.

关 键 词：急性创面 外科清创 负压封闭引流 炎症反应 

分 类 号：R641[医药卫生—外科学]