负压封闭引流术治疗四肢创伤复杂创面治疗的临床观察
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摘要
目的分析四肢创伤复杂创面患者应用负压封闭引流术治疗的效果。方法选取2014年6月～2018年6月66例我院收治的四肢创伤复杂创面患者,应用随机序列法将抽取患者分为比对组(n=33)和观察组(n=33),所有患者均接受彻底清创以及全身抗炎处理,同时为其提供创面感染治疗、补液治疗、输血治疗以及创面清洁和缝合治疗,对存在骨折现象患者进行骨折复位。比对组患者同时采用常规换药治疗,应用植皮术并封闭创面,观察组患者应用负压封闭引流术,观察患者移植皮瓣或者皮片成活情况、骨折愈合情况、渗出物情况、并发症情况,对比治疗前后患者创面面积。结果比对组患者治疗优良率为84.85%,观察组患者治疗优良率为96.97%,两组患者临床疗效经对比差异有统计学意义(χ~2=19.237,P=0.015)。比对组出现并发症患者共计8例,总发生率为24.24%,观察组出现并发症患者共计3例,总发生率为9.09%,两组患者并发症总发生率差异有统计学意义(χ~2=13.238,P=0.033)。两组患者治疗前创面面积比较,差异无统计学意义(t=1.835,P=0.074),治疗后观察组患者创面面积明显小于比对组患病者,两组差异有统计学意义(t=15.263,P=0.031)。结论四肢创伤复杂创面患者应用负压封闭引流术疗效显著且有助于提升患者治疗安全性,具有较高的临床应用价值。
Objective To analyze the effect of negative pressure closed drainage in the treatment of complex wounds of extremities. Methods Sixty-six patients with complicated trauma wounds of the extremities admitted to our hospital from June 2014 to June 2018 were divided into the comparison group(n=33) and the observation group(n=33) by random sequence method.All patients received thorough debridement and systemic anti-inflammatory treatment,as well as wound infection treatment,fluid rehydration treatment,blood transfusion treatment,wound cleaning and suture treatment,and fracture reduction for patients with fracture.Patients in the comparison group were treated with conventional dressing change,skin grafting and wound closure,and patients in the observation group were treated with negative pressure sealing drainage.The survival,fracture healing,exudate and complications of the grafted skin flap or flap were observed,and the wound area of the patients before and after treatment was compared. Results The rate of excellent and good treatment was 84.85% in the comparison group,and 96.97% in the observation group.The difference in clinical efficacy between the two groups was statistically significant(χ~2=19.237,P=0.015).The comparison group had a total of 8 patients with complications,with a total incidence of 24.24%.The observation group had 3 patients with complications,with a total incidence of 9.09%.The difference in the total incidence of complications between the two groups was statistically significant(χ~2=13.238,P=0.033).There was no statistically significant difference in wound area between the two groups before the treatment(t=1.835,P=0.074).After treatment,the wound area of the observation group was significantly smaller than that of the comparison group.The difference between the two groups was statistically significant(t=15.263,P=0.031). Conclusion The effect of vacuum-sealing drainage in patients with complicated wounds of extremities is significant and helpful to improve the safety of patients,which has a high clinical application value.
Objective To analyze the effect of negative pressure closed drainage in the treatment of complex wounds of extremities. Methods Sixty-six patients with complicated trauma wounds of the extremities admitted to our hospital from June 2014 to June 2018 were divided into the comparison group(n=33) and the observation group(n=33) by random sequence method.All patients received thorough debridement and systemic anti-inflammatory treatment,as well as wound infection treatment,fluid rehydration treatment,blood transfusion treatment,wound cleaning and suture treatment,and fracture reduction for patients with fracture.Patients in the comparison group were treated with conventional dressing change,skin grafting and wound closure,and patients in the observation group were treated with negative pressure sealing drainage.The survival,fracture healing,exudate and complications of the grafted skin flap or flap were observed,and the wound area of the patients before and after treatment was compared. Results The rate of excellent and good treatment was 84.85% in the comparison group,and 96.97% in the observation group.The difference in clinical efficacy between the two groups was statistically significant(χ~2=19.237,P=0.015).The comparison group had a total of 8 patients with complications,with a total incidence of 24.24%.The observation group had 3 patients with complications,with a total incidence of 9.09%.The difference in the total incidence of complications between the two groups was statistically significant(χ~2=13.238,P=0.033).There was no statistically significant difference in wound area between the two groups before the treatment(t=1.835,P=0.074).After treatment,the wound area of the observation group was significantly smaller than that of the comparison group.The difference between the two groups was statistically significant(t=15.263,P=0.031). Conclusion The effect of vacuum-sealing drainage in patients with complicated wounds of extremities is significant and helpful to improve the safety of patients,which has a high clinical application value.
引文
[1]刘如春,张瑞云.负压封闭引流术治疗四肢创伤复杂创面治疗的临床效果观察[J].临床医学工程,2014,21(9):1171-1172.
[2]李辉.负压封闭引流术治疗四肢创伤复杂创面治疗的效果分析[J].黑龙江医药科学,2017,40(5):57-58.
[3]钟孝政.负压封闭引流技术治疗四肢创伤复杂创面的临床应用研究[J].实用预防医学,2011,18(2):306-308.
[4]池凯,毋磊,陈龙金,李永林.评价四肢创面修复中应用皮肤牵张闭合器的效果及预后[J].中国医疗美容,2017,7(3):35-37.
[5]柏海涛.负压封闭引流术在3例截肢术后伤口愈合的应用[J].饮食保健,2016,3(20):185-186.
[6]黄绍雄.应用负压封闭引流技术治疗四肢创伤复杂创面的临床探讨[J].中国现代药物应用,2015,6(14):104-105.
[7]刘丹,陈子华.负压封闭引流技术治疗四肢创伤复杂创面的临床应用研究[J].中国卫生产业,2012,10(29):152-152.
[8]施万义,侯凤娟,王玉林.可冲洗负压封闭引流技术在四肢复杂性创面修复中的应用[J].包头医学院学报,2015,31(12):41-42.
[9]周炎,刘世清,瞿新丛,潘晓辉,等.保留内植物结合负压封闭引流技术治疗四肢骨折术后早期感染[J].生物骨科材料与临床研究,2015,12(6):54-57,63.
[10]刘羽,袁正江.负压封闭引流术与加压包扎对于四肢创面一期游离植皮术的疗效对比[J].中国医学工程,2015,23(6):134,137.
[11]罗杰,陆道望,陈顺兴,游嵚.改进型负压封闭引流技术治疗骨科复杂创面的临床效果分析[J].岭南现代临床外科,2016,16(4):472-475.
[12]郭丙杰.负压封闭引流技术治疗四肢创伤复杂创面的疗效观察[J].河南外科学杂志,2015,19(2):97.
[13]冯卓文.评价VSD技术治疗在四肢创伤复杂创面中的应用价值[J].疾病监测与控制,2017,11(7):528-529.
[14]代强,吴礼孟,孙充州,等.负压封闭引流技术治疗四肢创伤复杂创面的临床效果探讨[J].检验医学,2016,28(B09):212-213.
[15]陈芹.负压封闭引流术在骨科四肢创伤治疗中的临床效果分析[J].心理医生,2017,23(9):62-63.
[2]李辉.负压封闭引流术治疗四肢创伤复杂创面治疗的效果分析[J].黑龙江医药科学,2017,40(5):57-58.
[3]钟孝政.负压封闭引流技术治疗四肢创伤复杂创面的临床应用研究[J].实用预防医学,2011,18(2):306-308.
[4]池凯,毋磊,陈龙金,李永林.评价四肢创面修复中应用皮肤牵张闭合器的效果及预后[J].中国医疗美容,2017,7(3):35-37.
[5]柏海涛.负压封闭引流术在3例截肢术后伤口愈合的应用[J].饮食保健,2016,3(20):185-186.
[6]黄绍雄.应用负压封闭引流技术治疗四肢创伤复杂创面的临床探讨[J].中国现代药物应用,2015,6(14):104-105.
[7]刘丹,陈子华.负压封闭引流技术治疗四肢创伤复杂创面的临床应用研究[J].中国卫生产业,2012,10(29):152-152.
[8]施万义,侯凤娟,王玉林.可冲洗负压封闭引流技术在四肢复杂性创面修复中的应用[J].包头医学院学报,2015,31(12):41-42.
[9]周炎,刘世清,瞿新丛,潘晓辉,等.保留内植物结合负压封闭引流技术治疗四肢骨折术后早期感染[J].生物骨科材料与临床研究,2015,12(6):54-57,63.
[10]刘羽,袁正江.负压封闭引流术与加压包扎对于四肢创面一期游离植皮术的疗效对比[J].中国医学工程,2015,23(6):134,137.
[11]罗杰,陆道望,陈顺兴,游嵚.改进型负压封闭引流技术治疗骨科复杂创面的临床效果分析[J].岭南现代临床外科,2016,16(4):472-475.
[12]郭丙杰.负压封闭引流技术治疗四肢创伤复杂创面的疗效观察[J].河南外科学杂志,2015,19(2):97.
[13]冯卓文.评价VSD技术治疗在四肢创伤复杂创面中的应用价值[J].疾病监测与控制,2017,11(7):528-529.
[14]代强,吴礼孟,孙充州,等.负压封闭引流技术治疗四肢创伤复杂创面的临床效果探讨[J].检验医学,2016,28(B09):212-213.
[15]陈芹.负压封闭引流术在骨科四肢创伤治疗中的临床效果分析[J].心理医生,2017,23(9):62-63.
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