负压封闭引流联合局部氧疗在老年病人深Ⅱ度烧伤创面愈合中的作用

Effect of negative pressure wound therapy combined with local oxygen therapy in elderly patients with deep second degree burn wounds

目的探讨负压封闭引流联合局部氧疗在老年深Ⅱ度烧伤病人创面愈合中的临床疗效。方法将79例老年烧伤病人(共92个创面)随机分为常规治疗组(A组)26例,负压封闭引流组(B组)26例,负压封闭引流联合局部氧疗组(C组)27例,3组深Ⅱ度烧伤创面分别为32、30、30个。A组每日创面清创消毒后行包扎换药治疗,B组创面清创后给予持续负压封闭引流治疗,C组在负压封闭引流基础上给予创面局部氧疗,3周为一疗程,治疗3周后评价临床疗效,包括创面细菌培养阳性率、疼痛评分、创面愈合率、创面愈合时间以及瘢痕情况。结果治疗3周后,B组及C组创面愈合率、创面愈合时间均大于A组﹙P均<0.05﹚,疼痛评分及创面细菌培养阳性率均低于A组﹙P均<0.05﹚。B组及C组创面愈合率、创面愈合时间比较差异有统计学意义﹙P<0.05﹚,疼痛评分及创面细菌培养阳性率差异无统计学意义﹙P>0.05﹚。C组温哥华瘢痕量表评分明显低于A组和B组﹙P均<0.05﹚。结论负压封闭引流联合局部氧疗可以促进老年病人深Ⅱ度烧伤创面愈合速度与质量,临床疗效满意。

Objective To investigate the clinical efficacy of negative pressure wound therapy combined with local oxygen therapy in elderly patients with deep second degree burn wounds. Methods Seventy-nine elderly burn patients（ 92 wounds） were randomly divided into routine treatment group（ group A,n = 26）,negative pressure wound therapy group（ group B,n = 26）,and negative pressure wound therapy combined with local oxygen therapy group（ group C,n = 27）. Deep second degree burn wounds were 32,30 and 30 respectively in three groups. Group A was treated by routine enswathement,and group B was treated with negative pressure wound therapy,and group C received negative pressure wound therapy combined with local oxygen therapy for 3 weeks. The clinical efficacy was evaluated 3 weeks later,including bacterial culture positive rate,pain score,the wound healing rate,wound healing time,and scar scores. Results After 3 weeks,treatment,the wound healing rate and wound healing time in group B and group C were higher than those in group A（ P0. 05）,and bacterial culture positive rate and pain score were lower than those of group A（ P 0. 05）. The wound healing rate and wound healing time between group B and group C showed statistical differences（ P 0. 05）,and there was no significant difference in pain score and bacterial culture positive rate between the two groups（ P0. 05）.The score of vancouver scar scale in group C was lower than that in group A and group B（ P0. 05）.Conclusions Negative pressure wound therapy combined with local oxygen therapy can promote the healing speed and healing quality of deep second degree burn wounds in elderly patients,and the clinical efficacy is satisfactory.