负压封闭引流技术治疗四肢创伤皮肤修复患者的效果及其对创面细菌耐药性的影响
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摘要
目的探讨负压封闭引流技术在四肢创伤皮肤修复患者治疗中的疗效及其对创面细菌耐药性的影响。方法选取2014年1月～2016年1月进行治疗的四肢创伤修复患者90例,根据随机数字表法分为研究组和对照组,每组各45例。研究组使用负压封闭引流技术进行治疗,对照组进行传统的换药治疗。比较两组治疗前后的创伤面积、并发症发生率及临床疗效。结果治疗前,两组创伤面积比较差异无统计学意义(P>0.05);治疗后,研究组创伤面积小于对照组(P<0.05),研究组治疗的总有效率高于对照组(P<0.05),研究组并发症发生率低于对照组(P<0.05);治疗后,研究组的主要病原菌对于抗生素的耐药性低于对照组(P<0.05)。结论负压封闭引流技术对于四肢创伤修复患者的治疗具有较好的临床疗效,且对创面细菌耐药性的影响较小,是治疗四肢创伤修复较理想的方式,可在临床推广应用。
Objective To explore the curative effect of using specific negative pressure in the treatment of limb trauma skin repair in patients with closed drainage technique and its effect on patients with drug resistance. Methods 90 limb trauma repair patients were randomly divided into study group and control group,45 in each group. The study group was treated with VSD. The control group was treated with traditional dressing. Results Before treatment, the trauma area of the two groups had no significant difference(P>0.05). After treatment, the trauma area of study group was significantly less than that of control group(P<0.05). The total effective rate in study group was significantly higher than that of the control group(P<0.05). The complication rate of study group was significantly lower than that of control group(P<0.05). The drug resistance of the main pathogens to antibiotics of study group was significantly lower than that of the control group(P<0.05). Conclusion VSD technique has good clinical curative effect for the treatment of patients with limb trauma repair, and the influence of drug resistance in patients with small, which is an ideal way to treat limb trauma repair and can be popularized and applied widely in clinic.
Objective To explore the curative effect of using specific negative pressure in the treatment of limb trauma skin repair in patients with closed drainage technique and its effect on patients with drug resistance. Methods 90 limb trauma repair patients were randomly divided into study group and control group,45 in each group. The study group was treated with VSD. The control group was treated with traditional dressing. Results Before treatment, the trauma area of the two groups had no significant difference(P>0.05). After treatment, the trauma area of study group was significantly less than that of control group(P<0.05). The total effective rate in study group was significantly higher than that of the control group(P<0.05). The complication rate of study group was significantly lower than that of control group(P<0.05). The drug resistance of the main pathogens to antibiotics of study group was significantly lower than that of the control group(P<0.05). Conclusion VSD technique has good clinical curative effect for the treatment of patients with limb trauma repair, and the influence of drug resistance in patients with small, which is an ideal way to treat limb trauma repair and can be popularized and applied widely in clinic.
引文
[1] 薛福珍,姚艳粉.负压封闭引流技术在四肢创伤创面修复中的应用[J].山东医药,2016,56(3):102-103.
[2] 丁柱,朱兆洪,吴文锐.负压封闭引流技术治疗四肢开放性创伤的常见问题分析及对策[J].创伤外科杂志,2015,8(3):266-266.
[3] 张军,杨淮河,徐亚平,等.VSD技术在四肢创伤合并大面积皮肤软组织缺损患者中的应用[J].海南医学,2015,26(20):3062-3063.
[4] 张睿,文科,杨艳秋,等.负压封闭引流技术在创伤序贯救治中的应用[J].中华全科医学,2017,15(3):401-403.
[5] Krueger CA,Rivera JC,Tennent DJ,et al.Late amputation may not reduce complications or improve mental health in combat-related,lower extremity limb salvage patients [J].Injury-international Journal of the Care of the Injured,2015,46(8):1527-1532.
[6] 陈绍站,宋健.负压封闭引流技术对断肢(指)再植术后患者创面修复的影响[J].临床外科杂志,2016,24(2):136-138.
[7] 殷耀斌,钟文耀,杨辰,等.负压封闭引流应用于保肢患者创面引流量的相关研究[J].中国骨与关节杂志,2015,3(12):957-960.
[8] 李铁军,孙玉花,吴文侠,等.骨科创伤及感染创面应用负压封闭引流技术治疗的临床疗效评价[J].山西医药杂志,2017,46(7):811-812.
[9] 刘军,陈峰,杨辰,等.VSD技术结合游离股前外侧皮瓣修复四肢大面积皮肤缺损的疗效研究[J].创伤外科杂志,2016,7(2):118-119.
[10] 胡南松,胡志彦,吕伟胜,等.创伤部位对四肢骨折术后感染患者病原菌及耐药性的影响[J].中华医院感染学杂志,2017,27(6):1329-1332.
[11] Gage MJ,Yoon RS,Egol KA,et al.Uses of Negative Pressure Wound Therapy in Orthopedic Trauma[J].Orthopedic Clinics of North America,2015,46(2):227-228.
[12] 罗宝宁,王国新.负压封闭引流技术治疗软组织缺损导致的开放性骨折的临床疗效观察[J].实用临床医药杂志,2017,21(1):115-116.
[13] 邹永通,刘晓军,练祝平,等.股前外侧穿支皮瓣移植在四肢严重创伤后皮肤缺损修复中的应用[J].海南医学,2017,28(11):1854-1856.
[14] 李延宏,李培武.负压封闭引流术在软组织损伤中的应用[J].中国临床研究,2015,28(8):1048-1050.
[15] Kodde IF,Kaas L,Es NV,et al.The effect of trauma and patient related factors on radial head fractures and associated injuries in 440 patients[J].Bmc Musculoskeletal Disorders,2015,16(1):135-136.
[16] 王叶武,金玉梅,张勇,等.皮片化结合VSD技术在四肢大面积撕脱伤治疗中的运用[J].实用骨科杂志,2016,22(5):464-467.
[17] 任有亮,彭笳宸,李政道,等.四肢创伤性骨折术后细菌感染及耐药的地域性特征分析[J].中华创伤骨科杂志,2016,18(3):226-232.
[18] Uzkeser H,Karatay S,Erdemci B,et al.Efficacy of manual lymphatic drainage and intermittent pneumatic compression pump use in the treatment of lymphedema after mastectomy:a randomized controlled trial[J].Breast Cancer,2015,22(3):300-307.
[19] 康慧鑫,彭丹丹,陈永霞,等.自制封闭式负压引流装置应用于四肢软组织缺损创面的疗效观察[J].局解手术学杂志,2017,26(7):514-518.
[20] 史宗新,王世坤,丛云海,等.锁定加压接骨板治疗四肢骨折发生并发症的原因分析及处理[J].中华创伤骨科杂志,2015,17(3):268-270.
[2] 丁柱,朱兆洪,吴文锐.负压封闭引流技术治疗四肢开放性创伤的常见问题分析及对策[J].创伤外科杂志,2015,8(3):266-266.
[3] 张军,杨淮河,徐亚平,等.VSD技术在四肢创伤合并大面积皮肤软组织缺损患者中的应用[J].海南医学,2015,26(20):3062-3063.
[4] 张睿,文科,杨艳秋,等.负压封闭引流技术在创伤序贯救治中的应用[J].中华全科医学,2017,15(3):401-403.
[5] Krueger CA,Rivera JC,Tennent DJ,et al.Late amputation may not reduce complications or improve mental health in combat-related,lower extremity limb salvage patients [J].Injury-international Journal of the Care of the Injured,2015,46(8):1527-1532.
[6] 陈绍站,宋健.负压封闭引流技术对断肢(指)再植术后患者创面修复的影响[J].临床外科杂志,2016,24(2):136-138.
[7] 殷耀斌,钟文耀,杨辰,等.负压封闭引流应用于保肢患者创面引流量的相关研究[J].中国骨与关节杂志,2015,3(12):957-960.
[8] 李铁军,孙玉花,吴文侠,等.骨科创伤及感染创面应用负压封闭引流技术治疗的临床疗效评价[J].山西医药杂志,2017,46(7):811-812.
[9] 刘军,陈峰,杨辰,等.VSD技术结合游离股前外侧皮瓣修复四肢大面积皮肤缺损的疗效研究[J].创伤外科杂志,2016,7(2):118-119.
[10] 胡南松,胡志彦,吕伟胜,等.创伤部位对四肢骨折术后感染患者病原菌及耐药性的影响[J].中华医院感染学杂志,2017,27(6):1329-1332.
[11] Gage MJ,Yoon RS,Egol KA,et al.Uses of Negative Pressure Wound Therapy in Orthopedic Trauma[J].Orthopedic Clinics of North America,2015,46(2):227-228.
[12] 罗宝宁,王国新.负压封闭引流技术治疗软组织缺损导致的开放性骨折的临床疗效观察[J].实用临床医药杂志,2017,21(1):115-116.
[13] 邹永通,刘晓军,练祝平,等.股前外侧穿支皮瓣移植在四肢严重创伤后皮肤缺损修复中的应用[J].海南医学,2017,28(11):1854-1856.
[14] 李延宏,李培武.负压封闭引流术在软组织损伤中的应用[J].中国临床研究,2015,28(8):1048-1050.
[15] Kodde IF,Kaas L,Es NV,et al.The effect of trauma and patient related factors on radial head fractures and associated injuries in 440 patients[J].Bmc Musculoskeletal Disorders,2015,16(1):135-136.
[16] 王叶武,金玉梅,张勇,等.皮片化结合VSD技术在四肢大面积撕脱伤治疗中的运用[J].实用骨科杂志,2016,22(5):464-467.
[17] 任有亮,彭笳宸,李政道,等.四肢创伤性骨折术后细菌感染及耐药的地域性特征分析[J].中华创伤骨科杂志,2016,18(3):226-232.
[18] Uzkeser H,Karatay S,Erdemci B,et al.Efficacy of manual lymphatic drainage and intermittent pneumatic compression pump use in the treatment of lymphedema after mastectomy:a randomized controlled trial[J].Breast Cancer,2015,22(3):300-307.
[19] 康慧鑫,彭丹丹,陈永霞,等.自制封闭式负压引流装置应用于四肢软组织缺损创面的疗效观察[J].局解手术学杂志,2017,26(7):514-518.
[20] 史宗新,王世坤,丛云海,等.锁定加压接骨板治疗四肢骨折发生并发症的原因分析及处理[J].中华创伤骨科杂志,2015,17(3):268-270.