三期换药法治疗骶尾部藏毛窦切除术后的随机对照研究  

A Randomized Controlled Study on Three-Sage Dressing Change Method for the Treatment of Post-Sacrococcygeal Pilonidal Sinus Resection

作　　者：邢紫婷 李晓华 XING Ziting;LI Xiaohua(Graduate School of Hebei University of Traditional Chinese Medicine,Shijiazhuang Hebei 050091,China;Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Hebei University of Traditional Chinese Medicine,Cangzhou Hebei 061000,China)

机构地区：[1]河北中医学院研究生院,河北石家庄050091 [2]河北中医学院附属沧州中西医结合医院,河北沧州061000

出　　处：《中医药导报》2022年第11期66-70,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：河北省中医药管理局项目(2022589)。

摘　　要：目的:观察三期换药法在骶尾部藏毛窦切除术后中的应用效果,并分析其对创面愈合的影响。方法:将60例符合纳入标准的骶尾部藏毛窦患者随机分为治疗组和对照组各30例,所有患者均行窦道切除伤口开放术。对照组患者术后常规应用凡士林纱条换药;治疗组患者术后早期(2~7 d)予红油膏纱条换药,中期(8~21 d)予生肌玉红膏纱条换药,后期(22 d后)予生肌散外敷。观察并分析两组患者的创面愈合情况(愈合率和愈合时间)、疼痛评分(VAS)、肉芽组织评分;术后28 d评价临床疗效。结果:治疗组总有效率为100%(30/30),对照组总有效率为93.33%(28/30),两组比较,差异无统计学意义(P>0.05)。两组患者创面愈合情况比较,治疗组患者创面愈合时间短于对照组,差异有统计学意义(P<0.05)。两组患者术后7、14、21 d愈合率、肉芽组织评分、VAS评分均有所改善(P<0.05);治疗组患者术后不同时间点的愈合率均高于对照组,差异均有统计学意义(P<0.05);术后7、14 d,治疗组患者VAS评分、肉芽组织评分均优于对照组,差异均有统计学意义(P<0.05);术后21 d,两组患者VAS评分、肉芽组织评分比较,差异无统计学意义(P>0.05)。结论:三期换药法在骶尾部藏毛窦切除术后中的应用具有较好效果,可减轻疼痛,促进创面愈合,具有临床应用价值。Objective:To observe the effect of three-stage dressing change method in the post-sacrococcygeal pilonidal sinus resection and to analyze its effect on wound healing.Methods:Totally 60 patients with sacrococcygeal pilonidal sinus who met the inclusion criteria were randomly divided into treatment and control groups,30 cases in each group.All patients underwent sinus resection and wound opening.Patients in the control group were routinely treated with vaseline gauze after surgery.Patients in the treatment group were given Hongyou ointment(红油膏)gauze in the early postoperative period(2~7 days),with Shengji Yuhong ointment(生肌玉红膏)gauze in the middle period(8~21 days)and Shengji powder(生肌散)in the late period(after 22 days).The wound healing(healing rate and healing time),pain score(VAS)and granulation tissue score were observed and analyzed,and the clinical efficacy was evaluated in 28 days.Results:The total effective rate was 100%(30/30)in treatment group and 93.33%(28/30)in control group,and the difference between the two groups was not statistically significant(P>0.05).When comparing the wound healing of the two groups,the treatment group showed shorter healing time than control group,and the difference was statistically significant(P<0.05).The healing rate,granulation tissue score and VAS score improved in both groups at 7,14,and 21 days postoperatively(P<0.05).The treatment group showed higher healing rate than control group at different time points postoperatively,and the differences were statistically significant(P<0.05).The treatment group showed better VAS score and granulation tissue score than control group at 7 and 14 days postoperatively,and the differences were statistically significant(P<0.05).There was no statistically significant difference in VAS scores and granulation tissue scores between the two groups at 21 days postoperatively(P>0.05).Conclusion:The application of the three-stage dressing change method shows a good effect on the post-sacrococcygeal pilonidal sinus resection,

关 键 词：骶尾部藏毛窦 窦道切除伤口开放术 三期换药法 红油膏 生肌玉红膏 生肌散 凡士林纱条 创面愈合 

分 类 号：R266[医药卫生—中医外科学]