负压封闭引流联合过氧化氢溶液冲洗在下肢静脉溃疡的应用  

Effect of vacuum sealing drainage combined with hydrogen peroxide irrigation in the treatment of venous leg ulcer

作　　者：陈忠 王吉琼 李伟人 Chen Zhong;Wang Jiqiong;Li Weiren(Department of Burn and Plastic Surgery,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学附属医院整形烧伤外科,贵阳550004

出　　处：《中华整形外科杂志》2022年第2期180-185,共6页Chinese Journal of Plastic Surgery

基　　金：贵阳市科技计划项目(筑科合同(201510001)社29号)。

摘　　要：目的观察负压封闭引流(VSD)联合过氧化氢溶液冲洗在下肢静脉溃疡创面治疗中的应用效果。方法收集2014年1月至2021年3月贵州医科大学附属医院整形烧伤外科收治的下肢静脉溃疡创面患者的临床资料,根据治疗方法分为2组,治疗组于手术清创后采用VSD联合过氧化氢溶液冲洗,对照组于手术清创后采用VSD联合生理盐水冲洗。记录VSD治疗时间,计算创面治疗有效率。根据VSD治疗情况行中厚皮片移植,计算皮肤移植存活优良率。结果共纳入55例患者,男32例,女23例,年龄35~86岁,术前病理检查除外恶性肿瘤所致溃疡。治疗组34例,对照组21例。治疗组VSD治疗时间(8.53±1.52)d,对照组(10.33±3.25)d,,治疗组时间缩短,差异具有统计学意义(t=2.39,P=0.025)。创面治疗有效率,治疗组为82.35%(28/34),对照组为57.14%(12/21),差异具有统计学意义(χ^(2)=4.16,P=0.041)。皮肤移植存活优良率,治疗组为91.18%(31/34),对照组为61.90%(13/21),差异具有统计学意义(χ^(2)=5.24,P=0.022)。结论VSD联合过氧化氢溶液冲洗是治疗下肢静脉溃疡创面的一种有效方法,可缩短创面准备时间,提高皮肤移植存活率。Objective To observe the effect of vacuum sealing drainage(VSD)combined with hydrogen peroxide irrigation in the treatment of venous leg ulcer(VLU).Methods The clinical data was focused on the cases with venous leg ulcer,who were treated by the Department of Plastic and Burn Surgery,Affiliated Hospital of Guizhou Medical University from January 2014 to March 2021.According to the treatment method,patients were divided into two groups.After debridement,the intervention group was irrigated with VSD combined with hydrogen peroxide,while the control group was irrigated with VSD combined with normal saline.The duration of VSD treatment was recorded,and the effective rate of wound treatment was calculated.According to the treatment situation,the medium thickness skin graft was performed,and the good survival rate of skin graft was calculated.Results A total of 55 patients were enrolled in this study.Aged 35 to 86 years old,including 32 males and 23 females.Before the procedure,all the above patients underwent pathological examination to exclude the ulcers caused by malignant tumors.There were 34 cases in the intervention group and 21 cases in the control group.The duration of VSD treatment in the intervention group was(8.53±1.52)d,and that in the control group was(10.33±3.25)d,and the difference was statistically significant(t=2.39,P=0.025).The effective rate of wound assessment was 82.35%(28/34)in the intervention group and 57.14%(12/21)in the control group;the difference was statistically significant(χ^(2)=4.16,P=0.041).The good survival rate of skin graft was 91.18%(31/34)in the intervention group and 61.90%(13/21)in the control group;the difference was statistically significant(χ^(2)=5.24,P=0.022).Conclusions VSD combined with hydrogen peroxide irrigation is an effective method to treat VLU,which can shorten the preparation time of wounds and improve the survival rate of skin grafts.

关 键 词：静脉曲张性溃疡 创伤和损伤 过氧化氢 负压封闭引流 冲洗 

分 类 号：R658.3[医药卫生—外科学]