VSD配合灌注冲洗方案对四肢骨折内固定术后感染及创面愈合的影响  

Effect of VSD combined with perfusion irrigation on infection and wound healing after internal fixation of extremities fractures

作　　者：赵旭 ZHAO Xu(Benxi First People's Hospital,Benxi 117000,China)

机构地区：[1]本溪市第一人民医院,117000

出　　处：《中国现代药物应用》2022年第23期42-44,共3页Chinese Journal of Modern Drug Application

摘　　要：目的 探讨负压封闭引流技术(VSD)配合灌注冲洗方案对四肢骨折内固定术后感染及创面愈合的影响。方法 96例行内固定术且发生术后感染的四肢骨折患者,按照电脑随机法分为A组和B组,每组48例。A组采用传统灌注冲洗治疗,B组采用VSD配合灌注冲洗治疗。比较两组患者治疗效果、临床指标(骨折愈合时间、肉芽组织生长时间、创面愈合时间、住院时间)、血清炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、血沉(ESR)]水平。结果 B组患者的总有效率为97.92%(47/48),A组患者的总有效率为85.42%(41/48),B组患者的治疗总有效率优于A组,差异具有统计学意义(P<0.05)。B组患者的骨折愈合时间、肉芽组织生长时间、创面愈合时间、住院时间分别为(8.25±1.17)周、(8.95±1.25)d、(9.68±1.47)d、(22.31±4.65)d,均明显短于A组的(11.25±2.16)周、(15.47±1.78)d、(15.43±1.25)d、(43.26±6.58)d,差异具有统计学意义(P<0.05)。治疗后,B组患者的hs-CRP、IL-6、IL-8、IL-10、ESR分别为(3.21±1.02)mg/L、(79.32±16.23)pg/ml、(85.69±20.48)pg/ml、(4.13±2.07)pg/ml、(14.09±2.49)mm/h,均明显低于A组的(5.36±1.23)mg/L、(112.08±23.61)pg/ml、(122.86±16.45)pg/ml、(6.29±2.17)pg/ml、(20.36±4.65)mm/h,差异具有统计学意义(P<0.05)。结论 四肢骨折内固定术后感染患者应用VSD配合灌注冲洗,可有效改善患者的临床指标,加速创面愈合速度,缩短患者的住院时间,效果显著,值得广泛推广和应用。Objective To discuss the effect of vacuum sealing drainage(VSD) combined with perfusion irrigation on infection and wound healing after internal fixation of extremities fractures.Methods A total of 96 patients with postoperative infection after internal fixation of extremities fractures were divided into group A and group B according to the computerized randomization method,with 48 cases in each group.Group A was treated with conventional perfusion irrigation,and group B was treated with VSD with perfusion irrigation.Both groups were compared in terms of therapeutic effect,clinical indexes(fracture healing time,granulation tissue growth time,wound healing time,hospitalization time),serum inflammatory factors [high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10),and erythrocyte sedimentation rate(ESR)] levels.Results The total effective rate was 97.92%(47/48) in group B and 85.42%(41/48) in group A;the total effective rate of group B was better than that of group A,and the difference was statistically significant(P<0.05).The fracture healing time,granulation tissue growth time,wound healing time and hospitalization time in group B were(8.25±1.17) weeks,(8.95±1.25) d,(9.68±1.47) d and(22.31±4.65) d,which were significantly shorter than(11.25±2.16) weeks,(15.47±1.78) d,(15.43±1.25) d and(43.26±6.58) d in group A,and the differences were all statistically significant(P<0.05).After treatment,the hs-CRP,IL-6,IL-8,IL-10 and ESR in group B were(3.21±1.02) mg/L,(79.32±16.23) pg/ml,(85.69±20.48) pg/ml,(4.13±2.07) pg/ml,and(14.09±2.49) mm/h,which were significantly lower than(5.36±1.23) mg/L,(112.08±23.61) pg/ml,(122.86±16.45) pg/ml,(6.29±2.17) pg/ml,and(20.36±4.65) mm/h in group A,and the differences were all statistically significant(P<0.05).Conclusion The application of VSD with perfusion irrigation in patients with postoperative infection after internal fixation of extremities fractures can effectively improve the clinical indexes,accelerate the woun

关 键 词：负压封闭引流技术 灌注冲洗 四肢骨折 内固定术 术后感染 创面愈合 

分 类 号：R687.3[医药卫生—骨科学]