可充气式气囊加压敷贴的研制及加压效果影响因素的病例对照研究

Design and application of inflatable pressure applicator on the treatment of femoral shaft fractures:case control study

目的:比较可充气式加压敷贴与传统加压包扎对外科手术伤口愈合的影响。方法:将2009年5月至2010年2月入院接受手术治疗的50例闭合性股骨干骨折患者分为两组,每组25例。其中A组为试验组:年龄38～60岁,平均(55.1±9.5)岁;男13例,女12例;车祸伤18例,高处坠落伤6例,意外跌伤1例;术后伤口采用气囊加压敷贴包扎。B组为对照组:年龄40～65岁,平均(56.5±9.2)岁;男15例,女10例;车祸伤13例,高处坠落伤6例,意外跌伤6例;采用传统环扎加压包扎。观察术后12h两组伤口引流量、患肢末梢血氧饱和度及患者满意率,以评价气囊式加压敷贴的加压及止血效果。结果:A组患者术后12h伤口引流量为(77.5±4.6)ml,低于同时间点B组术后伤口引流量(94.3±3.8)ml;术后12、24hA组患者末梢血氧饱和度分别为(98.3±1.1)%、(98.9±0.8)%,均高于B组(96.5±0.4)%及(97.0±0.3)%;术后患者满意率A组高于B组。结论:与环扎加压包扎比较,可充气式加压敷贴的加压止血效果无明显差异,但对患肢末梢血运的影响较小,且术后患者的不适感减轻。

Objective：To compare the influence on the postoperative wound healing between inflatable pressure applicator and traditional pressure dressing.Methods：From May 2009 to February 2010,50 patients with closed femoral shaft fractures were randomly divided into group A and group B,with 25 patients in each group.There were 13 males and 12 females in group A,ranging in age from 38 to 60 years,with an average of（55.1±9.5） years;of them,road accident was in 18 cases,fall from heigh was in 6 cases,accidental falling injury was in 1 case.There were 15 males and 10 females in group B,ranging in age from 40 to 65 years,with an average of（56.5±9.2） years;of them,road accident was in 13 cases,fall from heigh was in 6 cases,accidental falling injury was in 6 cases.There was no significant difference between two groups in clinical data.The postoperative wounds of group A were binded with dressing of inflatable pressure applicator;and of group B with traditional pressure dressing.Volume of drainage at 12 h after operation,saturation of blood oxygen at 12,24 h after operation,satisfactory rate of patients were compared between two groups.Results：Postoperative volume of drainage in group A was lower than that of group B,respectively was（77.5±4.6）,（94.3±3.8） ml.Saturation of blood oxygen at 12,24 h after operation in A group was respectively（98.3±1.1）%,（98.9±0.8）%,and in group B was respectively（96.5±0.4）%,（97.0±0.3）%;there was significant difference between two groups at the same time.Satisfactory rate of patients in A group was better than that of group B.Conclusion：Inflatable pressure applicator can obviously pressurize and stop bleeding for postoperative wounds,but no affect on peripheral blood supply and can improve discomfort of patients.