持续负压引流在胸部正中切口无菌性愈合不良中的应用效果  

Application Effects of Vacuum Sealing Drainage in Poor Aseptic Healing of Median Thoracic Incision

作　　者：张磊 韩青松[1] 李玉琢[1] 冯军鹏[1] 王敏[1] 彭海军[1] ZHANG Lei;HAN Qing-song;LI Yu-zhuo;FENG Jun-peng;WANG Min;PENG Hai-jun(Department of Thoracic Surgery,Hebei Chest Hospital,Shijiazhuang 050041,China)

机构地区：[1]河北省胸科医院胸外科,石家庄050041

出　　处：《临床误诊误治》2022年第5期88-91,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生厅青年科技课题(20200827)。

摘　　要：目的研究持续负压引流(VSD)在胸部正中切口无菌性愈合不良患者中的应用效果。方法收集2016年6月—2021年2月进行胸外科手术后发生切口无菌性愈合不良88例的临床资料,根据治疗方式不同分为研究组45例和对照组43例,研究组给予VSD治疗,对照组予以常规换药治疗。比较两组临床疗效、恢复情况、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]及并发症情况。结果研究组临床总有效率显著高于对照组(P<0.05)。研究组换药次数少于对照组,切口无明显渗液时间、创面愈合时间及住院时间短于对照组(P<0.05)。治疗后,两组血清TNF-α、IL-6、CRP水平均较治疗前降低,且研究组低于对照组(P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。结论对胸部正中切口无菌性愈合不良患者采用VSD的临床疗效显著,能够有效促进创面恢复,改善炎性因子水平,且治疗安全性高。Objective To study the application effects of vacuum sealing drainage(VSD)in patients with poor aseptic healing of median thoracic incision.Methods The clinical data of 88 cases with poor aseptic healing of the incision after thoracic surgery from June 2016 to February 2021 was collected.According to different treatment methods,they were divided into the research group(n=45)and the control group(n=43).The research group was given VSD treatment,and the control group was given routine dressing changes.The clinical efficacy,recovery,serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]and complications were compared between the two groups.Results The total effective rate in the research group was significantly higher than that in the control group(P<0.05).The number of dressing changes in the research group was less than that in the control group,and the time of no obvious incision exudation,wound healing time,and length of hospital stay in the research group were shorter than those in the control group(P<0.05).After treatment,the levels of serum TNF-α,IL-6 and CRP in the two groups were lower than those before treatment,and lower in the research group than in the control group(P<0.05).The total incidence of complications in the research group was lower than that in the control group(P<0.05).Conclusion The clinical efficacy of VSD treatment for patients with poor aseptic healing of median thoracic incision is significant,which can effectively promote wound recovery,improve the level of inflammatory factors,and has good treatment safety.

关 键 词：切口无菌性愈合不良 胸部正中切口 持续负压引流 肿瘤坏死因子-Α 白细胞介素-6 C反应蛋白 

分 类 号：R619[医药卫生—外科学]