不同方案治疗手足外科难愈性伤口的疗效评价

Therapeutic evaluation of different schemes in the treatment of refractory wounds of hand and foot

目的观察常规封闭式负压引流技术(VSD)、改良VSD和VSD联合金因肽方案治疗手足外科难愈性伤口的临床疗效。方法 99例患者随机分为A组(常规VSD组)、B组(改良VSD组)、C组(VSD联合金因肽组),每组各33例,观察不同组别的临床疗效和上皮化时间、愈合时间、引流管堵塞率、引流液细菌培养阳性率、创面愈合率的差异。结果 B组与C组的总有效率高于A组(P<0.05);B组与C组疗效差异无统计学意义(P>0.05);B组和C组的上皮化时间、创面愈合时间、引流液细菌培养阳性率、引流管堵塞率小于A组,创面愈合率高于A组(P<0.05);但B组与C组比较,其差异均无统计学意义(P>0.05)。结论相对于常规VSD而言,改良VSD和VSD联合金因肽方案治疗手足外科难愈性伤口较优,其中改良VSD能更好缓解VSD治疗期间存在的堵塞问题,VSD联合金因肽能促进伤口的愈合,值得临床进一步研究。

Objective To observe the clinical efficacy of routine closed suction drainage （VSD）,improved VSD,VSD combined with rhEGF in the treatment of refractory wounds of hand and foot.Methods Ninety-nine patients were randomly divided into group A （conventional VSD）,group B （modified VSD）,group C （VSD combined with rhEGF）,each with 33 cases.The clinical efficacy,epithelialization time,healing time,drainage rube blockage rate,positive rate of drainage fluid culture,wound healing rate were observed.Results The total effective rate of group B and group C were significantly higher than that of group A （P＜0.05）,but no significant difference was found between group B and group C （P＞0.05）.The epithelialization time,wound healing time,positive rate of drainage fluid culture,drainage tube blockage rate of group B and group C were significantly less than those of group A,while the wound healing rate were higher than that of group A （P＜0.05）,with no statistically significant difference between group B and group C （P＞0.05）.Conclusion Compared with the conventional VSD,the improved VSD and VSD combined with rhEGF have a better curative effect in the treatment of refractory wounds of hand and foot.Improved VSD may alleviate congestion problems better during the VSD treatment,and VSD combined with rhEGF can promote wound healing,which are worthy of further study.