负压封闭结合局部氧疗改善创伤性慢性伤口愈合的效果研究

Study on the wound healing efficacy of negative pressure wound therapy combined with topical oxygen therapy on the traumatic chronic wounds

目的探讨负压封闭结合局部氧疗改善创伤性慢性伤口愈合效果的作用,为慢性复杂伤口治疗探讨新思路和方法。方法对64例创伤性慢性伤口患者随机分为2组,每组32例,对照组给予负压封闭伤口治疗,观察组在负压封闭伤口治疗基础上局部给氧3 L/min,干预时间均为12 d,每3天更换一次敷料和管道。干预期后,采用标准湿性疗法或手术治疗至愈合或3个月为止。观察指标:2组干预0、3、6、9、12 d评估测量愈合计分与肉芽组织覆盖率,以及3个月内的治愈率和愈合时间。结果干预后12 d 2组愈合计分随治疗时间延长而下降,说明伤口治疗有效,但组间差异无统计学意义(P>0.05)。肉芽组织覆盖率随治疗时间增加而升高,以观察组升高更明显(P<0.001)。观察组治愈率高于对照组(87.50%vs59.38%,P<0.05),愈合时间缩短14 d(P<0.001)。结论负压封闭结合局部氧疗对于复杂难愈的创伤性慢性伤口是一种有效可行的新方法,可促进肉芽组织生长,提高治愈率和缩短愈合时间。

Objective To evaluate the wound healing efficacy of negative pressure wound therapy（NPWT） combined with topical oxygen therapy（TOT） on the traumatic chronic wounds,and to explore new conception and method for traumatic chronic wounds.Methods Sixty-four patients with traumatic chronic wounds were randomized into two groups（n=32）.Patients in the control group were treated by NPWT,and those in the intervention group were treated by NPWT and NPWT with TOT 3L/min.The treatment time lasted 12 days,and the dressing and tubes were changed every three days in the two groups.After 12 days,all the patients were treated by standard moist therapy or surgery until healing or three months.Indicators of observation： The pressure ulcer scale for healing（PUSH） scores and granulation covered rate at 0,3,6,9,and 12 days were measured,and healing rate and healing time during three months were calculated in the two groups.Results The PUSH scores were declined with intervention time during 12 days in the two groups,indicating the treatment was effective,but there was no significant difference between the two groups（P 0.05）.The granulation covered rate was increased with intervention time,and the granulation covered rate was higher in the intervention group than in the control group（P0.001）.The healing rate was higher in the intervention group than in the control group（87.50% vs 59.38%,P〉0.05）.The healing time of 14 days was shortened in the intervention group compared with the control group（P0.001）.Conclusion NPWT combined with TOT is an effective and feasible method for complicated traumatic chronic wounds,which can enhance granulation growth,rise healing rate and shorten healing time.