负压封闭引流治疗骶尾部藏毛窦术后创面疗效观察

Observation on Clinical Efficacy of Vacuum Sealing Drainage in the Treatment of Postoperative Wounds of Sacrococcygeal Pilonidal Sinus

目的对比分析负压封闭引流治疗骶尾部藏毛窦术后创面的临床疗效。方法按照随机数表法将2013年4月—2017年5月南昌大学第一附属医院中西医结合科收治的40例骶尾部藏毛窦患者随机分为观察组(20例)与对照组(20例),其中观察组患者于手术切除后采用负压封闭引流治疗术后创面,对照组患者于手术切除后采用一期缝合换药治疗术后创面,对比观察两组患者的创面假性愈合率及创面愈合时间。结果治疗过程中,观察组患者中发生创面假性愈合者1例,假性愈合发生率为5.0%,创面愈合时间为(25.26±3.58)d;对照组患者中发生创面假性愈合者6例,假性愈合发生率为30.0%,创面愈合时间为(33.27±5.23)d。两组患者创面假性愈合发生情况对比采用四格表资料的卡方检验,χ~2=4.329,P<0.05,差异具有统计学意义;两组患者创面愈合时间对比采用t检验,t=5.652,P<0.01,差异具有统计学意义。结论负压封闭引流治疗骶尾部藏毛窦术后创面,可有效促进创面愈合,降低创面假性愈合发生率,疗效显著,且安全性较高,值得临床推广使用。

Objective To analyze the clinical efficacy of vacuum sealing drainage（ VSD） in the treatment of postoperative wounds of sacrococcygeal pilonidal sinus. Methods Forty patients with sacrococcygeal pilonidal sinus admitted to the Integrated Traditional and Western Medicine Department of The First Affiliated Hospital of Nanchang University between April 2013 and May 2017 were randomly divided into an observation group（ 20 cases） and a control group（20 cases） according to the random number table. In the observation group,the postoperative wounds of pilonidal sinus were managed with VSD while that in the control group was managed with traditional dressing change after suturing. The wound pseudo healing rate and wound healing time between the two groups were observed and compared. Results During the management,one case showed pseudo healing in the observation group in which the pseudo healing rate was 5. 0% and the wound healing time was（25. 26 ± 3. 58） d,while 6 cases developed pseudo healing in the control group in which the pseudo healing rate was 30. 0% and the wound healing time was（33. 27 ± 5. 23） d. The Chi-square test of fourfold table was used for the comparison of pseudo healing cases between the two groups,and results showed statistically significant difference（ χ~2= 4. 329,P〈0. 05）; t test was used for the comparison of wound healing time between the two groups and the results also showed statistically significant difference（ t = 5. 652,p 0. 01）. Conclusion In the treatment of postoperative wounds of sacrococcygeal pilonidal sinus,VSD can effectively promote wound healing and decrease the pseudo wound healing rate,with high safety,deserving to be promoted in clinical practice.