负压封闭引流治疗肠道皮肤瘘的临床应用

Treatment of intestinal cutaneous fistula by vacuum sealing drainage device

目的:探讨封闭负压引流装置(VSD)治疗肠皮肤瘘的临床作用。方法 :收集2009年1月—2014年12月腹部手术后发生肠皮肤瘘患者24例,其中16例接受封闭负压引流装置治疗(治疗组),8例接受常规治疗(对照组)。对伤口愈合时间、临床换药次数、治疗费用、相关并发症以及患者疼痛评分等指标进行比较。结果:封闭负压引流治疗组的换药次数、愈合时间、治疗费用、体温恢复正常时间、肠内营养开始时间以及继发相关并发症发生率均显著少(低)于对照组(P<0.05),而患者的疼痛评分差异无统计学意义(P>0.05)。结论:封闭负压引流装置可以加速肠外皮肤瘘腹壁切口愈合,减轻患者的痛苦和经济负担,减少医务人员的换药工作量,具有很大的临床应用价值。

Objective： To evaluate effects of vacuum sealing drainage （VSD） device in the treatment of abdominal intestinal cutaneous fistula. Methods： Treatment of VSD device was per- formed in 16 patients with postoperative abdominal intestinal cutaneous fistula from January 2009 to December 2014. Another 8 cases of same type disease that underwent treatment of conventional surgery dressing were set as control group. For the total 24 patients the number of surgery dressing, the length of wound healing time,surgery dressing-related expense, nutrition improvement,temper- ature recovery time, and related complication were analyzed. Results： The times of surgery dress-ing, the length of wound healing time, surgery dressing-related expense, temperature recovery time, and related complication in VSD group were all significantly lower than that in control group, other- wise nutrition improvement was more superior（P〈 0.05）, Conclusion： Reasonable application of VSD device in abdominal intestinal fistula patients can accelerate wound healing, reduce suffering and economic burden of patients, decrease the workload of medical staff. It has obvious advantages compared to conventional open surgery dressing.