负压封闭引流技术联合外用万古霉素治疗骶尾部难愈性压疮的效果  

Effect of Vacuum Sealing Drainage Combined with Topical Vancomycin in the Treatment of Sacrococcygeal Refractory Pressure Sores

作　　者：刘旭良[1] 李伯庭 郑介柏[1] 王兆杰 方雄明 张瑞[1] 温钰滢 LIU Xu-liang;LI Bo-ting;ZHENG Jie-bo;WANG Zhao-jie;FANG Xiong-ming;ZHANG Rui;WEN Yu-ying(Department of Orthopedics,Guangzhou Twelfth People's Hospital,Guangzhou 510620,Guangdong,China)

机构地区：[1]广州市第十二人民医院骨科,广东广州510620

出　　处：《医学信息》2022年第17期37-40,共4页Journal of Medical Information

摘　　要：目的 观察负压封闭引流(VSD)联合万古霉素治疗骶尾部难愈性压疮的效果。方法 选取广州市第十二人民医院2014年1月-2020年6月创面分泌物细菌培养结果为革兰氏阳性菌感染的骶尾部难愈性压疮患者60例为研究对象,按照处理创面的方式分为A、B、C三组,每组20例。A组采用VSD联合外用万古霉素治疗,B组单纯应用VSD治疗,C组采用传统换药治疗。比较三组治疗前后创面面积缩小比例、肉芽增大比例、BWAT评分变化及创面分期变化。结果 三组创面面积缩小程度比较,差异有统计学意义(P<0.05),其中创面面积缩小程度:A组>B组>C组;三组肉芽增大比例比较,差异有统计学意义(P<0.05),其中肉芽增大比例:A组>B组>C组;三组BWAT评分降低程度比较,差异有统计学意义(P<0.05),其中BWAT评分降低程度:A组>B组>C组;三组创面分期变化比较,差异无统计学意义(P>0.05)。结论 外用万古霉素可应用于骶尾部难愈性压疮的治疗,联合应用VSD相对其他治疗方式具有一定优势。Objective To observe the effect of vacuum sealing drainage(VSD) combined with vancomycin in the treatment of sacrococcygeal refractory pressure sores.Methods From January 2014 to June 2020,60 patients with sacrococcygeal refractory pressure sores infected by Gram-positive bacteria were selected from the bacterial culture results of wound secretions in Guangzhou Twelfth People’s Hospital as the research objects.According to the way of wound treatment,they were divided into three groups:A,B and C,with 20 cases in each group.Group A was treated with VSD combined with topical vancomycin,group B was treated with VSD alone,and group C was treated with traditional dressing change.The changes of wound area reduction ratio,granulation enlargement ratio,BWAT score and wound staging before and after treatment were compared among the three groups.Results There were significant differences in the degree of area reduction among the three groups( P group B>group C.There was significant difference in the proportion of granulation enlargement among the three groups( Pgroup B>group C.There was significant difference in the degree of BWAT score reduction among the three groups(P group B >group C.There was no significant difference in wound stage among the three groups(P>0.05).Conclusion Topical vancomycin can be used in the treatment of sacrococcygeal refractory pressure sores,and the combined application of VSD has certain advantages over other treatment methods.

关 键 词：万古霉素 压迫性溃疡 封闭负压引流技术 

分 类 号：R632.1[医药卫生—外科学]