微动力负压技术用于儿童四肢及躯干创面植皮术中的疗效观察  

Clinical effect of micro-dynamic negative pressure wound therapy on skin grafting of limbs and trunk wounds of childron

作　　者：张梦思 麻艺群 付晋凤 朱辉 袁子萱[1] Zhang Mengsi;Ma Yiqun;Fu Jinfeng;Zhu Hui;Yuan Zixuan(Department of Burns and Plastic Surgery,Kunming Childrn′s Hospital,Yunnan Children′s Medical Center,Kuming 650031,China)

机构地区：[1]昆明市儿童医院烧伤整形外科云南省儿童医学中心,650031

出　　处：《中华损伤与修复杂志（电子版）》2021年第5期398-405,共8页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：昆明市卫生健康委员会卫生科研基金资助项目(2019-04-03-001)。

摘　　要：目的对比儿童四肢及躯干创面植皮术中应用打包加压、负压封闭引流(VSD)技术和微动力负压技术(MDNPWT)固定皮片的效果,分析MDNPWT应用于儿童创面四肢及躯干植皮术的临床疗效。方法采用前瞻性随机对照研究,选择2019年8月至2021年5月昆明市儿童医院收治的符合入组标准并完成研究的患儿共90例,将患儿按随机数字表法分为MDNPWT组、VSD组及打包组。3组患儿入院后均行术前常规创面处理,手术清创后取自体大张中厚皮移植修复创面,MDNPWT组使用微动力负压护创敷料固定移植皮片,其余2组分别使用VSD及传统打包方法固定移植皮片。3组患儿均于术后7 d拆除敷料,常规换药至创面完全愈合。观察并记录3组患儿手术时间、创面愈合率、术后换药次数、手术及术后治疗总费用、疼痛情况(FLACC评分)及术后不良反应发生情况。数据比较分别采用单因素方差分析、SNK-q检验、重复测量方差分析及χ^(2)检验。结果MDNPWT组与打包组及VSD组的手术时长分别为(46.1±10.5)、(77.0±11.6)、(53.9±19.6)min,组间总体比较差异有统计学意义(F=85.54,P<0.01);MDNPWT组与打包组比较,差异有统计学意义(q=17.51,P<0.01),与VSD组比较,差异有统计学意义(q=3.79,P<0.01)。MDNPWT与打包组、VSD组的创面愈合率分别为(96.3±3.2)、(77.2±10.9)、(91.8±7.3)%,组间总体比较差异有统计学意义(F=47.85,P<0.01);MDNPWT组与打包组比较,差异有统计学意义(q=13.11,P<0.01),MDNPWT组与VSD组比较,差异无统计学意义(q=3.79,P>0.05)。MDNPWT组与打包组及VSD组的术后换药次数分别为(2.4±1.2)、(8.4±2.8)、(2.5±1.7)次,组间总体比较差异有统计学意义(F=82.36,P<0.01);MDNPWT组与打包组比较比较,差异有统计学意义(q=15.66,P<0.01),与VSD组比较,差异无统计学意义(q=0.25,P>0.05)。MDNPWT组与打包组及VSD组的手术及术后治疗费用分别为(5253.7±652.3)、(7545.6±736.8)、(6543.3±481.4)元,组间总�Objective To compare the effects of applying packing compression,vacuum sealing drainage(VSD)technology and micro-dynamic negative pressure therapy(MDNPWT)in skin grafting on children′s limbs and trunk wounds,and analyze the clinical efficacy of MDNPWT in children′s wound skin grafting.Methods The prospective randomized controlled study were used,from August 2019 to May 2021,Kunming Children′s Hospital admitted a total of 90 children who met the enrollment criteria and completed the study.The children were divided into MDNPWT group and VSD group according to the random number table method.And packaging group.After admission,the three groups of children underwent routine preoperative wound treatment.During the operation,the wound was debrided and then a large medium thick leather was used to repair the wound.The MDNPWT group used microdynamic negative pressure wound dressing to fix the skin graft,and the other two groups used VSD and traditional packaging methods to fix the skin graft.piece.The dressings were removed 7 days after the operation of the children in the 3 groups,and the dressing was changed routinely until the wounds healed completely.Observed and recorded the operation time,wound healing rate,number of postoperative dressing changes,surgical and postoperative treatment costs,pain(FLACC score)and postoperative adverse reactions in the three groups.The measurement data were compared by one-way analysis of variance test,SNK-q test and repeated measures analysis of variance,the count data were compared byχ^(2) test.Results The operation time of MDNPWT group,packing group and VSD group:(46.1±10.5),(77.0±11.6),(53.9±19.6)min,respectively,the difference between the groups was statistically significant(F=85.54,P<0.01);The MDNPWT group was compared with the packaged group,the difference was statistically significant(q=17.51,P<0.01),and compared with the VSD group,the difference was statistically significant(q=3.79,P<0.01).The wound healing rates of MDNPWT,packaged group and VSD group were(96.3±3.2)

关 键 词：创伤和损伤 负压伤口疗法 皮肤移植 儿童 微动力 

分 类 号：R726.5[医药卫生—儿科]