对冲引流治疗骨科术后深部感染的临床效果及对血清炎症指标的影响  

Clinical Effect of Hedged Drainage in the Treatment of Deep Infection after Orthopedic Surgery and Its Influence on Serum Inflammatory Indexes

作　　者：李泉胜 邵巍 徐建勇 毕凌峰 LI Quansheng;SHAO Wei;XU Jianyong;BI Lingfeng(Department of OrthopaedicsⅠ,Guixi People's Hospital,Guixi 335400,China;不详)

机构地区：[1]贵溪市人民医院骨一科,江西贵溪335400

出　　处：《中国医学创新》2024年第2期58-62,共5页Medical Innovation of China

基　　金：2023年度第一批鹰潭指导性科技计划项目(2023-9-33194)。

摘　　要：目的:探讨对冲引流治疗骨科术后深部感染的临床效果及对血清炎症指标的影响。方法:选取2020年7月—2023年4月贵溪市人民医院收治的骨科术后深部感染患者60例,随机分为对照组和观察组,每组30例。对照组采用常规扩创术治疗,观察组在对照组基础上联合对冲引流治疗。比较两组创口愈合率、疼痛评分、血清炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)、红细胞沉降率(ESR)]及凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)]水平。结果:观察组创口愈合率(93.33%)高于对照组(73.33%)(P<0.05)。术后3、7、14 d,观察组视觉模拟评分法(VAS)评分均低于对照组(P<0.05)。术后14 d,观察组WBC、CRP、ESR、FIB水平均低于对照组,APTT、PT、TT均短于对照组(P<0.05)。结论:对冲引流治疗骨科术后深部感染能提高创口愈合率,减轻疼痛程度,且能抑制血清炎症因子水平,改善凝血功能。Objective:To investigate the clinical effect of hedged drainage in the treatment of deep infection after orthopedic surgery and its influence on serum inflammatory indexes.Method:A total of 60 patients with deep infection after orthopedic surgery admitted to Guixi People's Hospital from July 2020 to April 2023 were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with conventional debridement,and the observation group was treated with hedged drainage on the basis of control group.The wound healing rate,pain score,serum inflammatory indexes[white blood cell count(WBC),C reactive protein(CRP),erythrocyte sedimentation rate(ESR)]and coagulation function indexes[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)]were compared between the two groups.Result:The wound healing rate of observation group(93.33%)was higher than that of control group(73.33%)(P<0.05).At 3,7 and 14 days after surgery,visual analogue scale(VAS)scores in the observation group were lower than those in the control group(P<0.05).14 d after surgery,the levels of WBC,CRP,ESR and FIB in the observation group were lower than those in the control group,and APTT,PT,TT in the observation group were shorter than those in the control group(P<0.05).Conclusion:Hedged drainage in the treatment of deep infection after orthopedic surgery can improve the wound healing rate,reduce the degree of pain,inhibit the level of serum inflammatory factors and improve coagulation function.

关 键 词：深部感染 对冲引流 创口愈合 炎症因子 

分 类 号：R687[医药卫生—骨科学] R446.5[医药卫生—外科学]