MEBO联合负压封闭引流治疗感染性创伤创面疗效观察
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摘要
目的观察MEBO联合负压封闭引流治疗感染性创伤创面的临床疗效。方法将2015年1月—2017年3月河南科技大学附属三门峡市中心医院收治的68例感染性创伤患者随机分为治疗组(36例)与对照组(32例),其中对照组患者采用传统换药疗法治疗,治疗组患者采用MEBO联合负压封闭引流治疗,对比观察两组患者的创面愈合时间、愈合效果、感染控制情况及换药时的疼痛程度。结果治疗组患者创面愈合时间为(26.0±1.8)d,对照组患者创面愈合时间为(55.0±1.6)d,两组对比,t=69.845,P<0.01,差异具有统计学意义;治疗组患者创面乙级愈合者30例,丙级愈合者6例,对照组患者创面乙级愈合者14例,丙级愈合者18例,两组对比,u=3.377,P<0.01,差异具有统计学意义;换药过程中治疗组患者的创面疼痛评分为(1.2±0.1)分,对照组患者的创面疼痛评分为(4.0±0.6)分,两组对比,t'=26.079,P<0.01,差异具有统计学意义;植皮前创面细菌培养结果显示,治疗组有5例患者存在细菌感染,对照组有13例患者存在细菌感染,两组对比,χ~2=6.222,P<0.05,差异具有统计学意义。结论 MEBO联合负压封闭引流治疗感染性创伤创面,可有效促进创面愈合,缓解创面疼痛,预防瘢痕增生,疗效显著,值得临床推广应用。
Objective To observe the clinical effect of MEBT/MEBO combined with vacuum sealing drainage in the treatment of infected wound. Methods 68 patients with infected wounds, admitted to Sanmenxia Central Hospital affiliated to Henan University of Science and Technology between January 2015 and March 2017, were randomly divided into two groups: treatment group(36 cases),which was treated with MEBO combined with vacuum sealing drainage and control group(32 cases), which was treated with traditional dressing change. Wound healing time, wound healing effect, infection control and pain intensity were observed and compared. Results Wound healing time was( 26. 0 ± 1. 8) d, for patients in treatment group,and(55. 0 ± 1. 6) d for patients in control group,the difference between the two groups was statistically significant(t =69. 845, P<0. 01). In treatment group, 30 patients achieved healing by second intention and 6 patients achieved henling by third intention. In control group, the wound healing time was(55. 0 ± 1. 6) d,14 patients achieved healing by second intention and 18 patients achieved healing by third intention. The difference between the two groups was statistically significant(u =3. 377,P <0.01). During dressing change, pain score for treatment group was(1.2±0. 1) points while for control group it was(4. 0 ± 0. 6) points. The comparison showed statistically significant difference(t'= 26. 079, P < 0. 01). The results of bacteria culture before skin grafting showed 5 patients in treatment group got bacterial infection and 13 patients in control group got bacterial infection. The comparison of the two groups showed statistically significant difference(χ~2 = 6. 222, P < 0. 05). Conclusion MEBO combined with vacuum sealing drainage in the treatment of infected wound can effectively promote wound healing and relieve pain, prevent wound infection and hyperplastic scar formation. It is deserved to be promoted in clinical practice due to its excellent efficacy.
Objective To observe the clinical effect of MEBT/MEBO combined with vacuum sealing drainage in the treatment of infected wound. Methods 68 patients with infected wounds, admitted to Sanmenxia Central Hospital affiliated to Henan University of Science and Technology between January 2015 and March 2017, were randomly divided into two groups: treatment group(36 cases),which was treated with MEBO combined with vacuum sealing drainage and control group(32 cases), which was treated with traditional dressing change. Wound healing time, wound healing effect, infection control and pain intensity were observed and compared. Results Wound healing time was( 26. 0 ± 1. 8) d, for patients in treatment group,and(55. 0 ± 1. 6) d for patients in control group,the difference between the two groups was statistically significant(t =69. 845, P<0. 01). In treatment group, 30 patients achieved healing by second intention and 6 patients achieved henling by third intention. In control group, the wound healing time was(55. 0 ± 1. 6) d,14 patients achieved healing by second intention and 18 patients achieved healing by third intention. The difference between the two groups was statistically significant(u =3. 377,P <0.01). During dressing change, pain score for treatment group was(1.2±0. 1) points while for control group it was(4. 0 ± 0. 6) points. The comparison showed statistically significant difference(t'= 26. 079, P < 0. 01). The results of bacteria culture before skin grafting showed 5 patients in treatment group got bacterial infection and 13 patients in control group got bacterial infection. The comparison of the two groups showed statistically significant difference(χ~2 = 6. 222, P < 0. 05). Conclusion MEBO combined with vacuum sealing drainage in the treatment of infected wound can effectively promote wound healing and relieve pain, prevent wound infection and hyperplastic scar formation. It is deserved to be promoted in clinical practice due to its excellent efficacy.
引文
[1]胡浩,曹开学,王景,等.负压封闭引流技术治疗胫腓骨骨折内固定术后感染16例疗效分析[J].临床急诊杂志,2015,16(6):451-453.
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[3]丁明华,张丽,秦国强,等.再生医疗技术治疗慢性难愈性溃疡210例临床体会[J].中国烧伤创疡杂志,2014,26(6),426-428.
[4]陈俊柱,胡广健,蒋佑升.负压封闭引流技术治疗严重皮肤逆行撕脱伤12例[J].广东医学,2014,35(13):2067-2068.
[5]Winter GD.Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig[J].J Wound Care,1995,4(8):366-367.
[6]宁强华,陈得一,唐华丽,等.湿性愈合理论在治疗压疮中的临床疗效观察[J].检验医学与临床,2014,12(9):1269-1270.
[7]郑臣校,吴治森,刘思景,等.骨科感染创面修复研究进展[J].现代中西医结合杂志,2015,24(16):1815-1818.
[8]汪华侨,常湘珍,朱庆棠,等.负压封闭引流技术专题座谈会专家意见[J].中华显微外科杂志,2014,37(3):209.
[9]陈方凯,李晓辉,龚海粟,等.MEBT/MEBO治疗慢性难愈性创面的临床疗效分析[J].中国烧伤创疡杂志,2014,26(2):119-124.
[10]王洪生.皮肤原位再生医疗技术治疗糖尿病足溃疡的临床诊治规范[J].中国烧伤创疡杂志,2016,28(3):155-191.
[11]肖摩,赵俊祥,李俊,等.皮肤原位再生复原技术对深Ⅱ度烧伤治疗的临床疗效总结[J].中国烧伤创疡杂志,2011,23(1):27-52.
[12]李爱莲.MEBO治疗下肢骨折合并严重挫裂伤创面的护理体会[J].中国烧伤创疡杂志,2013,25(3):203-205.
[13]袁云平.湿润烧伤膏治疗深度烧伤骨质外露16例[J].菏泽医学专科学校学报,2015,27(4):45-46.
[14]易泽洪,黄亮,刘桃.应用MEBT/MEBO治疗颜面部皮肤擦挫伤体会[J].中国烧伤创疡杂志,2011,23(6):480-481.
[2]陈少华.负压封闭引流技术治疗骨科创伤及感染创面的护理体会[J].齐齐哈尔医学院学报,2015,36(9):1386-1387.
[3]丁明华,张丽,秦国强,等.再生医疗技术治疗慢性难愈性溃疡210例临床体会[J].中国烧伤创疡杂志,2014,26(6),426-428.
[4]陈俊柱,胡广健,蒋佑升.负压封闭引流技术治疗严重皮肤逆行撕脱伤12例[J].广东医学,2014,35(13):2067-2068.
[5]Winter GD.Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig[J].J Wound Care,1995,4(8):366-367.
[6]宁强华,陈得一,唐华丽,等.湿性愈合理论在治疗压疮中的临床疗效观察[J].检验医学与临床,2014,12(9):1269-1270.
[7]郑臣校,吴治森,刘思景,等.骨科感染创面修复研究进展[J].现代中西医结合杂志,2015,24(16):1815-1818.
[8]汪华侨,常湘珍,朱庆棠,等.负压封闭引流技术专题座谈会专家意见[J].中华显微外科杂志,2014,37(3):209.
[9]陈方凯,李晓辉,龚海粟,等.MEBT/MEBO治疗慢性难愈性创面的临床疗效分析[J].中国烧伤创疡杂志,2014,26(2):119-124.
[10]王洪生.皮肤原位再生医疗技术治疗糖尿病足溃疡的临床诊治规范[J].中国烧伤创疡杂志,2016,28(3):155-191.
[11]肖摩,赵俊祥,李俊,等.皮肤原位再生复原技术对深Ⅱ度烧伤治疗的临床疗效总结[J].中国烧伤创疡杂志,2011,23(1):27-52.
[12]李爱莲.MEBO治疗下肢骨折合并严重挫裂伤创面的护理体会[J].中国烧伤创疡杂志,2013,25(3):203-205.
[13]袁云平.湿润烧伤膏治疗深度烧伤骨质外露16例[J].菏泽医学专科学校学报,2015,27(4):45-46.
[14]易泽洪,黄亮,刘桃.应用MEBT/MEBO治疗颜面部皮肤擦挫伤体会[J].中国烧伤创疡杂志,2011,23(6):480-481.