持续双负压微压力引流联合重组人表皮生长因子在压疮皮瓣修复术后的应用效果  

Effect of Continuous Double Negative Pressure Drainage Combined with rhEGF for Pressure Ulcer after Skin Flap Repair

作　　者：黄兆伦[1] 黄晓栋[1] 万里[1] 叶东成 叶茂球 牛占国[1] 李佳伟 黄静[1] HUANG Zhao-lun;HUANG Xiao-dong;WAN Li;YE Dong-cheng;YE Mao-qiu;NIU Zhan-guo;LI Jia-wei;HUANG Jing(Department of Burns and Plastic Surgery,Dongguan People's Hospital,Dongguan 523000,Guangdong,China)

机构地区：[1]东莞市人民医院烧伤整形外科,广东东莞523000

出　　处：《中国现代手术学杂志》2021年第4期284-288,共5页Chinese Journal of Modern Operative Surgery

基　　金：东莞市社会科技发展项目(201950715001890)。

摘　　要：目的探讨持续双负压微压力引流联合重组人表皮生长因子(rhEGF)在压疮皮瓣修复术后的应用效果。方法回顾性分析2018年1月至2020年6月在我科行压疮皮瓣修复术的66例患者的临床资料,按照术后处理方式分为两组,各33例:对照组行单纯压疮皮瓣修复术治疗,观察组行压疮皮瓣修复术后持续行双负压微压力引流联合rhEGF治疗。比较两组相关指标、临床疗效和并发症情况。结果观察组创面愈合时间及抗生素使用时间均少于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IL-6、IL-8及TNF-α水平均较治疗前降低,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。压疮皮瓣修复术后21 d评价临床效果:观察组优16例,良14例,可1例,差2例,临床总有效率为90.91%;对照组优11例,良12例,可5例,差5例,临床总有效率为69.70%;两组临床总有效率比较,观察组高于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症5例(15.15%),其中皮肤坏死2例,感染3例;对照组术后并发症14例(42.42%),其中皮肤坏死及感染各7例;两组术后并发症率比较,观察组低于对照组,差异有统计学意义(P<0.05)。结论持续双负压微压力引流联合rhEGF能促进创面愈合,减少抗生素使用时间,降低炎性细胞因子释放和并发症率,值得临床推广应用。Objective To explore the effect of continuous double negative pressure drainage with micro pressure combined with recombinant human epidermal growth factor(rhEGF)for pressure ulcer after skin flap repair.Methods A total of 66 cases with pressure ulcer underwent skin flap repair in our hospital from January 2018 to June 2020 were analyzed retrospectively.According to measures following the surgery,all cases were divided into two groups with 33 cases for each group:The operation of simple flap repair was applied in the control group,while continuous double negative pressure drainage combined with rhEGF after the surgery of flap repair in the observation group.Results Both the healing time of wound and applying time of antibiotics were shorter in the observation group than those in the control group(P<0.05).The level of serum interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)was lower after treatment than those before treatment in both groups,and the index of mention above were lower in the observation group than those in the control group(P<0.05).The clinical effect revealed 16 of excellence,14 of good,1 of fair and 2 of poor in the observation group,and 11 of excellence,12 of good,5 of fair and 5 of poor in the control group,and there was remarkable difference in the total effective rate between the two groups(90.91%vs.69.70%,P<0.05).Postoperative complication was found in 5 cases(15.15%)including 2 of skin necrosis and 3 of infection in the observation group,and was in 14 cases(42.42%)including 7 of skin necrosis and 7 of infection in the control group;the incidence of complication of the observation group was lower than that of the control group(P<0.05).Conclusion The management of continuous double negative pressure drainage combined with rhEGF can improve the wound healing,shorten the applying time of antibiotics,reduce the release of inflammatory cytokines and decrease the incidence of complications after skin flap repair for pressure ulcer,and it is worthy of clinical application.

关 键 词：引流术 双负压 溃疡 压力性 皮瓣修复术 

分 类 号：R632.1[医药卫生—外科学]