刘伟源, 许贤君, 陈燕图. 含氧液冲洗在负压封闭引流治疗慢性创面中的应用[J]. 蚌埠医科大学学报, 2016, 41(7): 903-905. DOI: 10.13898/j.cnki.issn.1000-2200.2016.07.021
    引用本文: 刘伟源, 许贤君, 陈燕图. 含氧液冲洗在负压封闭引流治疗慢性创面中的应用[J]. 蚌埠医科大学学报, 2016, 41(7): 903-905. DOI: 10.13898/j.cnki.issn.1000-2200.2016.07.021
    LIU Wei-yuan, XU Xian-jun, CHEN Yan-tu. Application of the oxygen loaded fluid irrigation combined with VSD in the treatment of chronic wound[J]. Journal of Bengbu Medical University, 2016, 41(7): 903-905. DOI: 10.13898/j.cnki.issn.1000-2200.2016.07.021
    Citation: LIU Wei-yuan, XU Xian-jun, CHEN Yan-tu. Application of the oxygen loaded fluid irrigation combined with VSD in the treatment of chronic wound[J]. Journal of Bengbu Medical University, 2016, 41(7): 903-905. DOI: 10.13898/j.cnki.issn.1000-2200.2016.07.021

    含氧液冲洗在负压封闭引流治疗慢性创面中的应用

    Application of the oxygen loaded fluid irrigation combined with VSD in the treatment of chronic wound

    • 摘要: 目的:观察负压封闭引流联合含氧液冲洗治疗慢性创面的临床效果。方法:慢性创面患者68例,均入院后行清创术,随机均分为观察组和对照组,各34例。对照组采用负压封闭引流联合0.9%氯化钠注射液冲洗治疗,观察组采用负压封闭引流联合含氧液冲洗治疗,治疗7 d后,测量组织液氧分压,拆除负压封闭引流装置,评估创面床条件及患者全身情况,行Ⅱ期手术。观察并计算治疗7 d后2组的细菌清除率、创面肉芽组织覆盖率、泡沫干瘪率,并于治疗过程中记录计算引流管堵塞发生率及Ⅱ期手术方式及皮片或皮瓣移植成活率。结果:观察组引流管堵塞率与对照组差异无统计学意义(P>0.05);观察组泡沫干瘪率、肉芽组织覆盖率和细菌清除率均高于对照组(P<0.05~P<0.01);治疗7 d后,观察组创面局部组织液氧分压为(112.80±4.01)mmHg,显著高于对照组的(41.32±4.03)mmHg(P<0.01)。2组手术方式分别为皮片移植和皮瓣移植,差异无统计学意义(P>0.05),但观察组皮片移植成活率和皮瓣移植成活率均显著高于对照组(P<0.01),随访3~12个月,2组所有皮片或皮瓣成活者创面均愈合良好,功能外形满意,未发现复发病例。结论:慢性创面患者进行清创后,采用负压封闭引流联合含氧液冲洗治疗,之后进行Ⅱ期手术,疗效好,值得推广。

       

      Abstract: Objective: To observe the clinical effects of vacuum sealing drainage(VSD) combined with oxygen loaded fluid irrigation in the treatment of chronic wounds.Methods: Sixty-eight chronic wounds patients treated with debridement were randomly divided into the observation group and control group(34 cases each group).The observation group were treated with VSD combined with oxygen loaded fluid irrigation,and the control group were treated with VSD combined with normal saline irrigation.After 7 days of treatment,the tissue fluid oxygen partial pressure of all patients was measured,and the closed negative pressure drainage device was dismantled.After assessing the wound and whole body condition,the patients were treated with phase Ⅱ operation.After 7 days,the bacterial clearance rate,wound granulation tissue coverage,foam dry rate,incidence of drainage blockage,phase Ⅱ operation methods and survival rate of skin graft or skin flap transplantation in two groups were calculated and recorded.Results: The difference of the drainage tube blockage rate between two groups was not statistically significant(P>0.05).The foam dry rate,granulation tissue coverage rate and bacterial clearance rate in observation group were higher than those in control group(P<0.05 to P<0.01).After 7 days of treatment,the local wound tissue oxygen partial pressure in observation group(12.80±4.01) mmHg was significantly higher than that in control group(41.32±4.03) mmHg(P<0.01).The skin graft and skin flap transplantation were used in two groups,the difference of which was not statistically significant(P>0.05).The survival rates of skin graft and skin flap transplantation in observation group were significant higher than those in control group(P<0.01).All patients were followed up for 1 to 3 months.The healing of all skin or skin flap were good,the function and appearance of which was satisfied,and no recurrence was found.Conclusions: The effects of the stage Ⅱ surgery,VSD drainage combined with oxygen loaded fluid irrigating after debriding in the treatment of chronic wounds are good,which is worthy of clinical promotion.

       

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