负压封闭引流联合高压氧治疗对难愈性创面的影响
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摘要
目的探讨负压封闭引流(VSD)联合高压氧治疗(HBOT)对难愈性创面的影响。方法回顾性分析2017年1月—2017年12月收治150例难愈性创面患者的临床资料。根据不同治疗方式将患者分为A、B和C组,每组50例。A组采用传统换药方法,B组采用单独VSD治疗,C组采用VSD联合HBOT治疗。比较3组的临床疗效和治疗相关指标。结果 B组和C组的临床总有效率和血管内皮生长因子的标记指数明显高于A组,且C组高于B组(P<0.05)。B组和C组的伤口愈合时间、住院时间以及肉芽组织覆盖创面80%以上所用的覆盖时间明显短于A组,且C组短于B组(P<0.05)。结论采用VSD联合HBOT治疗难愈性创面的临床效果显著,能提高血管内皮生长因子的表达,加速创面的愈合。
Objective To investigate effect of vacuum sealing and drainage( VSD) combined with hyperbaric oxygenation( HBOT) on refractory wounds.Methods Clinical data of 150 patients with refractory wounds admitted during January 2017 and December 2017 was retrospectively analyzed,and the patients were divided into group A,B and C( n = 50 for each group) according to different treatment methods.Group A was treated with traditional dressing changes,and group B was treated with VSD alone,while group C was treated with VSD combined with HBOT.Clinical efficacy and treatment related indexes were compared among 3 groups.Results Values of the clinical total effective rate and labelling index of vascular endothelial growth factor in group B and C were significantly higher than those in group A,and the values in group C was significantly higher than those in group B( P < 0.05).Times of wound healing,hospitalization and duration for more than 80% of the granulation tissue covered wound in group B and C were significantly shorter than those in group A,and the times in group C were significantly shorter than those in group B( P < 0.05).Conclusion VSD combined with HBOT is effective in treatment of refractory wounds.It may improve expression of vascular endothelial growth factor and accelerate wound healing.
Objective To investigate effect of vacuum sealing and drainage( VSD) combined with hyperbaric oxygenation( HBOT) on refractory wounds.Methods Clinical data of 150 patients with refractory wounds admitted during January 2017 and December 2017 was retrospectively analyzed,and the patients were divided into group A,B and C( n = 50 for each group) according to different treatment methods.Group A was treated with traditional dressing changes,and group B was treated with VSD alone,while group C was treated with VSD combined with HBOT.Clinical efficacy and treatment related indexes were compared among 3 groups.Results Values of the clinical total effective rate and labelling index of vascular endothelial growth factor in group B and C were significantly higher than those in group A,and the values in group C was significantly higher than those in group B( P < 0.05).Times of wound healing,hospitalization and duration for more than 80% of the granulation tissue covered wound in group B and C were significantly shorter than those in group A,and the times in group C were significantly shorter than those in group B( P < 0.05).Conclusion VSD combined with HBOT is effective in treatment of refractory wounds.It may improve expression of vascular endothelial growth factor and accelerate wound healing.
引文
[1]葛红.封闭负压引流技术在慢性难愈性创面中的应用[J].重庆医学,2017,46(A01):244-245.
[2]许献荣,倪俊,陈瑞彩,等.难愈性创面修复手术疗效及其影响因素分析[J].中国急救复苏与灾害医学杂志,2017,12(3):236-239.
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[5]郭志芹,韩学尧,沈景红.高压氧治疗糖尿病足溃疡的研究进展[J].国际内分泌代谢杂志,2017,37(2):108-111.
[6]王维平,王科科,李强,等.实用封闭式负压引流治疗难愈性创面的疗效观察[J].中国普通外科杂志,2010,19(9):1019-1021.
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[8]刘晓蓉,王昆,葛云霞,等.复方白玉散外敷治疗慢性难愈性创面30例临床研究[J].江苏中医药,2016,48(9):44-46.
[9]牟天易,简华刚.生物膜致慢性创面难以愈合的病理机制及其治疗[J].重庆医学,2016,45(7):988-990.
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[11]杨红明.难愈性创面治疗进展与面临的挑战[J].中华烧伤杂志,2016,32(4):193-195.
[12]Chen B,Ha F,Yang Y,et al.Prophylactic vacuum sealing drainage(VSD)in the prevention of postoperative surgical site infections in pediatric patients with contaminated laparotomy incisions[J].Medicine,2017,96(13):e6511.
[13]刘桂喜,李少君,周淑娟,等.负压封闭引流技术在168例难愈合创面的应用及护理[J].武警后勤学院学报:医学版,2014,23(2):160-161.
[14]笪晓伟,郭海欧,陈海涛,等.负压封闭引流技术处理下肢大面积皮肤缺损临床疗效研究[J].创伤与急危重病医学,2014,2(5):309-311.
[15]朱琳怡,傅育红,莫兰.封闭负压引流联合局部间歇给氧对糖尿病足的临床疗效观察[J].护士进修杂志,2017,32(20):1890-1893.
[16]叶松林,陈立,覃晓峰,等.封闭式负压引流术联合游离植皮、皮瓣移植术治疗四肢难治性感染创面的效果及对疼痛的影响[J].中国医药导报,2016,13(2):109-112.
[17]马平,刘洋,李小强,等.封闭负压引流联合局部氧疗对糖尿病大鼠烫伤创面愈合的影响[J].解放军医药杂志,2017,29(3):1-4,14.
[18]Elkins-Williams S T,Marston W A,Hultman C S.Management of the chronic burn wound[J].Clin Plast Surg,2017,44(3):679-687.
[19]莫波,何琴,马娟,等.高压氧治疗对直肠周围脓肿患者术后创面愈合及相关血清指标的影响[J].海南医学院学报,2016,22(14):1535-1537.
[20]张彩虹,杨美玲,葛昌甫,等.重组牛碱性成纤维细胞生长因子结合高压氧促进肛肠病术后创面愈合的临床研究[J].陕西医学杂志,2016,45(4):461-462.
[21]聂郁林,陈懿,刘春霞.高压氧辅助治疗慢性胸壁放射性溃疡1例及文献复习[J].重庆医学,2016,45(12):1728.
[22]张志云,徐姝娟,王方,等.负压封闭引流技术联合局部氧疗在重度压疮治疗中的应用[J].皖南医学院学报,2017,36(5):504-506.
[23]刘伯语,申科,翟锴华,等.负压封闭引流技术联合局部加氧治疗糖尿病足慢性创面疗效观察[J].新乡医学院学报,2017,35(5):398-401.
[24]白永强,邵洪波,孟令敏,等.负压封闭引流与传统换药治疗烧伤创面疗效比较[J].海南医学,2016,27(10):1672-1675.
[25]张稳存,张生东,葛昌甫.中药熏治联合高压氧对肛肠病术后创面愈合的作用[J].中国中西医结合外科杂志,2016,22(4):397-399.
[26]孙亚楠,孙树,张挺,等.负压封闭引流技术在GustiloⅢ型开放性骨折术后难愈性创面感染治疗中的应用[J].山东医药,2016,56(23):80-82.
[2]许献荣,倪俊,陈瑞彩,等.难愈性创面修复手术疗效及其影响因素分析[J].中国急救复苏与灾害医学杂志,2017,12(3):236-239.
[3]赵月荣,孟凡军,张学成,等.封闭负压引流技术在外科难愈性创面治疗中的应用[J].内蒙古医学杂志,2016,48(4):481-482.
[4]熊亮,马来祥,胡寅,等.负压辅助愈合治疗系统治疗难愈性创面21例疗效分析[J].江苏医药,2016,42(2):217-218.
[5]郭志芹,韩学尧,沈景红.高压氧治疗糖尿病足溃疡的研究进展[J].国际内分泌代谢杂志,2017,37(2):108-111.
[6]王维平,王科科,李强,等.实用封闭式负压引流治疗难愈性创面的疗效观察[J].中国普通外科杂志,2010,19(9):1019-1021.
[7]邢栋,李文毅,魏景超,等.改良持续负压引流法治疗难愈性创面的临床研究[J].中国现代医学杂志,2017,27(26):110-113.
[8]刘晓蓉,王昆,葛云霞,等.复方白玉散外敷治疗慢性难愈性创面30例临床研究[J].江苏中医药,2016,48(9):44-46.
[9]牟天易,简华刚.生物膜致慢性创面难以愈合的病理机制及其治疗[J].重庆医学,2016,45(7):988-990.
[10]Bather A T,Marsh C,Kirchner R S.The use of keratinbased wound products on refractory wounds[J].Int Wound J,2016,13(1):110-115.
[11]杨红明.难愈性创面治疗进展与面临的挑战[J].中华烧伤杂志,2016,32(4):193-195.
[12]Chen B,Ha F,Yang Y,et al.Prophylactic vacuum sealing drainage(VSD)in the prevention of postoperative surgical site infections in pediatric patients with contaminated laparotomy incisions[J].Medicine,2017,96(13):e6511.
[13]刘桂喜,李少君,周淑娟,等.负压封闭引流技术在168例难愈合创面的应用及护理[J].武警后勤学院学报:医学版,2014,23(2):160-161.
[14]笪晓伟,郭海欧,陈海涛,等.负压封闭引流技术处理下肢大面积皮肤缺损临床疗效研究[J].创伤与急危重病医学,2014,2(5):309-311.
[15]朱琳怡,傅育红,莫兰.封闭负压引流联合局部间歇给氧对糖尿病足的临床疗效观察[J].护士进修杂志,2017,32(20):1890-1893.
[16]叶松林,陈立,覃晓峰,等.封闭式负压引流术联合游离植皮、皮瓣移植术治疗四肢难治性感染创面的效果及对疼痛的影响[J].中国医药导报,2016,13(2):109-112.
[17]马平,刘洋,李小强,等.封闭负压引流联合局部氧疗对糖尿病大鼠烫伤创面愈合的影响[J].解放军医药杂志,2017,29(3):1-4,14.
[18]Elkins-Williams S T,Marston W A,Hultman C S.Management of the chronic burn wound[J].Clin Plast Surg,2017,44(3):679-687.
[19]莫波,何琴,马娟,等.高压氧治疗对直肠周围脓肿患者术后创面愈合及相关血清指标的影响[J].海南医学院学报,2016,22(14):1535-1537.
[20]张彩虹,杨美玲,葛昌甫,等.重组牛碱性成纤维细胞生长因子结合高压氧促进肛肠病术后创面愈合的临床研究[J].陕西医学杂志,2016,45(4):461-462.
[21]聂郁林,陈懿,刘春霞.高压氧辅助治疗慢性胸壁放射性溃疡1例及文献复习[J].重庆医学,2016,45(12):1728.
[22]张志云,徐姝娟,王方,等.负压封闭引流技术联合局部氧疗在重度压疮治疗中的应用[J].皖南医学院学报,2017,36(5):504-506.
[23]刘伯语,申科,翟锴华,等.负压封闭引流技术联合局部加氧治疗糖尿病足慢性创面疗效观察[J].新乡医学院学报,2017,35(5):398-401.
[24]白永强,邵洪波,孟令敏,等.负压封闭引流与传统换药治疗烧伤创面疗效比较[J].海南医学,2016,27(10):1672-1675.
[25]张稳存,张生东,葛昌甫.中药熏治联合高压氧对肛肠病术后创面愈合的作用[J].中国中西医结合外科杂志,2016,22(4):397-399.
[26]孙亚楠,孙树,张挺,等.负压封闭引流技术在GustiloⅢ型开放性骨折术后难愈性创面感染治疗中的应用[J].山东医药,2016,56(23):80-82.