改良负压封闭引流术在难愈性烧伤创面治疗中的应用

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英文篇名：Clinical application of modified vacuum sealing drainage in the treatment of refractory burn wounds 作者：安鸿肇 ; 王煜 ; 周小茜 ; 张丽 ; 刘晨 ; 肖厚安 英文作者：AN Hong-zhao;WANG Yu;ZHOU Xiao-qian;ZHANG Li;LIU Chen;XIAO Hou-an;Department of Burn, Plastic and Cosmetology,The Ninth Hospital of Xi′an City Affiliated to the Medical College of Xi′an Jiaotong University; 关键词：烧伤创面 ; 难愈性创面 ; 负压封闭引流术 ; 改良方法 英文关键词：Burn wound;;Refractory wound;;Vacuum sealing drainage;;Modified means 中文刊名：SMZW 英文刊名：Chinese Journal of Aesthetic and Plastic Surgery 机构：西安交通大学医学院附属西安市第九医院烧伤整形美容科; 出版日期：2019-07-15 出版单位：中国美容整形外科杂志 年：2019 期：v.30 语种：中文; 页：SMZW201907013 页数：4 CN：07 ISSN：21-1542/R 分类号：47-50

摘要

目的探讨改良负压封闭引流术(vacuum sealing drainage, VSD)对难愈性烧伤创面的治疗效果。方法选取自2013年2月至2016年10月收治的难愈性创面患者76例,按随机数字表法分为实验组(38例)和对照组(38例)。对照组患者采用常规VSD治疗;实验组患者采用改良VSD治疗,即在常规VSD治疗基础上增加银离子敷料覆盖创面。观察两组患者的治疗效果、创面愈合时间、敷料维持时间和住院时间以及创面细菌感染率并进行比较分析;采用视觉模拟评分法(visual analogue acale, VAS)对两组患者治疗前后的疼痛程度进行评价。结果实验组和对照组患者总有效率分别为92.11%(35/38)和73.68%(28/38),两组差异具有统计学意义(P<0.05);与对照组比较,实验组创面愈合时间与住院时间均明显缩短,辅料维持时间明显延长(P<0.05);两组患者治疗前的VAS评分比较,其差异无统计学意义(P>0.05);实验组治疗后的VAS评分明显低于对照组(P<0.05);实验组与对照组患者创面的细菌感染率分别为5.26%(2/38)和21.05%(8/38),两组差异具有统计学意义(P<0.05)。结论在常规VSD基础上增用银离子敷料可显著提高难愈性烧伤创面的疗效,有效缩短创面愈合时间,减少更换敷料的次数,从而降低创面细菌的感染率,具有临床推广价值。
        Objective To explore the clinical efficacy of modified vacuum sealing drainage(VSD) in the treatment of refractory burn wounds. Methods From February 2013 to October 2016, 76 patients with refractory burn wounds admitted to our hospital were selected and randomly divided into an experimental group(38 cases) and a control group(38 cases). Conventional VSD treatment was performed in the control group and modified VSD treatment was performed in the experimental group. In the experimental group, silver ion dressing was employed to cover the wound on the basis of conventional VSD. The clinical efficacy, healing time, and bacterial infection rate of the wound, dressing maintenance time, and hospitalization time were compared between the two groups. The pain degree of the two groups was assessed by the visual analogue scale(VAS) before and after treatment. Results The total rate of effectiveness of the experimental and control groups was 92.11%(35/38) and 73.68%(28/38), respectively. The difference was statistically significant(P<0.05).Compared with the control group, the wound healing time and hospitalization time of the experimental group was significantly shortened,and the dressing maintenance time was significantly prolonged(P<0.05). There was no statistically significant difference on VAS scores between the two groups before treatment(P>0.05), but the experimental group was significantly lower than the control group after treatment(P<0.05). The bacterial infection rate of the experimental and the control group was 5.26%(2/38) and 21.05%(8/38), respectively.The difference was statistically significant between the two groups(P<0.05). Conclusion The clinical efficacy of treatment for refractory burn wounds was significantly increased by adding silver ion dressing on the basis of conventional VSD. The modified VSD can significantly shorten the wound healing time and reduce the frequency of dressing replacement, so as to reduce the bacterial infection rate of the wound. This method has clinical promotion value.

引文

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