摘要
目的探讨痛风石破溃患者使用超声清创联合负压吸引治疗创面的临床疗效及安全性。方法选择2014年9月至2017年12月我科住院的痛风合并痛风石破溃的患者96例,随机分为2组(n=48):试验组[年龄(51.3±7.6)岁,病程(6.8±1.1)年,BMI(25.7±1.2),创面面积(1.62±0.23)cm~2]采取超声清创联合负压吸引术治疗,对照组[年龄(52.4±6.9)岁,病程(6.5±1.3)年,BMI(26.1±1.4),创面面积(1.65±0.21)cm~2]采取常规手工清创换药治疗。比较2组患者的创面愈合程度、治愈率、显效率,以及治疗前后患处视觉模拟疼痛评分(visual analogue scale,VAS),住院费用和不良反应发生情况。结果治疗后试验组:痛风石破溃创面疗效优于对照组(P<0.05);第5天的显效率和第10、15、20、25、30天的治愈率显著高于对照组,患处VAS评分显著低于对照组,差异均有统计学意义(P<0.05);2组间住院费用差异无统计学意义(P>0.05);试验组超声清创过程中出现2例(4.2%)患处剧烈疼痛,对照组3例(6.3%)出现延迟愈合,两组不良反应发生率差异无统计学意义(P>0.05)。结论超声清创联合负压吸引能够缩短痛风石破溃创面愈合时间、提高创面愈合质量、不增加不良反应发生率及总住院费用。
Objective To investigate the clinical effects and safety of vacuum sealing drainage(VSD) combined with ultrasonic debridement surgical system(UDSS) on the patients with gouty tophus ulceration. Methods Totally 96 patients suffering from gout and gouty tophus ulceration admitted in our department from September 2014 to December 2017 were recruited, and then randomly divided into 2 groups(n=48 for each group). The patients from the experiment group(51.3±7.6 years old, disease course of 6.8±1.1 years, BMI 25.7±1.2, wound area 1.62±0.23 cm~2) were treated with UDSS combined VSD, and those from the control group(52.4±6.9 years old, disease course of 6.5±1.3 years, BMI 26.1±1.4, wound area 1.65±0.21 cm~2) were treated with conventional surgical debridement. Wound healing, cure rate, effective rate, visual analogue scale(VAS) score before and after treatment, cost of hospitalization, and incidences of adverse reactions were observed and compared between the 2 groups. Results Compared with the control group, the experimental group obtained better wound healing(P<0.05), higher effective rate on day 5, and higher cure rates on days 10, 15, 20, 25 and 30, but lower VAS score after the treatment(P<0.05). There were no differences in the costs of hospitalization or incidences of adverse reactions between the 2 groups(P>0.05). Two cases(4.2%) from the experimental group experienced acute pain in affected area during ultrasonic debridement, and 3 cases(6.3%) had delayed healing. Conclusion UDSS combined with VSD can accelerate wound healing, improve healing outcome, and have no effect on the costs of hospitalization or incidences of adverse reactions.
引文
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