不同负压封闭引流方案在骨及软组织慢性感染患者中的应用研究

Application of different vacuum sealing drainage regimens in patients with chronic infections of bone and soft tissue

目的探究不同负压封闭引流方案在对骨及软组织慢性感染患者的应用效果。方法选取2013年1月-2016年1月于医院接受治疗的骨感染和软组织感染患者117例作为研究对象,随机分为对照组58例,实验组59例,对照组采用传统负压封闭引流方案进行治疗,实验组采用改良的负压封闭引流装置进行治疗,观察两组感染患者的术后症状改善时间、住院时间、创面清洁所需时间、创伤部位细菌培养情况、两组方案的有效率及患者的再次感染率。结果实验组与对照组感染患者症状改善时间分别为(2.1±0.4)h、(3.75±0.8)h;实验组与对照组感染患者住院时间分别为(6.4±0.7)d、(8.1±0.3)d;实验组创面清洁时间1h患者13例,多于对照组的9例,且实验组创面清洁所需时间>4h的患者数量为0,对照组34例,2~3h实验组患者45例,对照组患者15例,差异均有统计学意义(P<0.05);实验组主要细菌中大肠埃希菌11株、铜绿假单胞菌12株、金黄色葡萄球菌16株,对照组大肠埃希菌25株、铜绿假单胞菌26株、金黄色葡萄球菌30株、白假丝酵母14株;实验组患者治愈率为84.75%,明显高于对照组的51.72%(P<0.05);实验组再次感染率为16.95%明显低于对照组的27.59%(P<0.05)。结论改良的负压封闭引流技术在治疗骨及软组织感染方面比传统负压封闭引流技术治疗效果好。

OBJECTIVE To explore the application effect of different vacuum sealing regimens in patients with chronic infections of bone and soft tissue.METHODS A total of 117 cases of patients with infections of bone and soft tissue from Jan.2013 to Jan.2016 were selected as the study subjects,and were randomly divided into control group（58cases）and experimental group（59cases）.Patients in control group were treated with traditional vacuum sealing drainage,while in experimental group were treated with modified vacuum sealing drainage device.The symptoms improved time,hospital stay,wound cleaning time,bacterial culture of the wound sites,effectiveness of the two groups of regimens and the rate of re-infection of of the two groups of infected patients were observed.RESULTS The symptoms improved time were（2.1±0.4）h in experimental group and（3.75±0.8）h in control group.The time of hospitalization were（6.4±0.7）d in experimental group and（8.1±0.3）d in control group.The number of patients with wound cleaning time of 1hin experimental group was 13 cases,which was more than9 cases in control group.The number of patients with wound cleaning time more than 4hin experimental group was 0and in control group was 34 csaes,and the number of patients with wound cleaning time of 2~3hin experimental group was 45 cases and was 15 cases in control group,and the differences were significant（P〈0.05）.The main pathogens in experimental group were 11 strains of Escherichia coli,12 strains of Pseudomonas aeruginosa,and 16 strains of Staphylococcus aureus,and in control group were 25 strains of E.coli,26 strains of P.aeruginosa,30 strains of S.aureus,and 14 strains of Candida albicans.The cure rate of experimental group was84.75%,which was significantly higher than 51.72%of control group（P〈0.05）.The re-infection rate of experimental group was 16.95%,which was obviously lower than 27.59% of control group（P〈0.05）.CONCLUSION The modified vacuum sealing drainage technique is more effective in the treatment of bone and soft tissue infections than traditional vacuum sealing drainage technique.