闭式滴注灌洗联合负压引流技术治疗感染性压疮或皮肤溃疡的临床效果

Clinical effect of closed drip irrigation combined with vacuum sealing drainage in the treatment of infectious pressure sores or skin ulcers

目的探讨闭式滴注灌洗联合负压引流技术(VSD)治疗感染性压疮或皮肤溃疡的临床效果。方法选择2016年7月～2018年6月由本院(包括总院)收入院的96例压疮或外伤后皮肤溃疡(未纳入糖尿病)患者作为研究对象,按照是否愿意参与本次课题研究分为对照组(34例)与治疗组(62例)。对照组仅采用传统换药与清除创伤面的手段,而治疗组则除此之外结合闭式滴注灌洗与VSD治疗,对比分析两组患者的各临床指标。结果治疗组的感染控制时间为(13.1±4.5)d,显著短于对照组的(21.4±5.2)d,差异有统计学意义(P<0.05)。治疗组患者中,新鲜溃疡创面吸引(10.0±0.8)d伤口植皮,其余创面时间为(14.5±2.5)d,个别病例换药至创面愈合,平均创面符合植皮手术时间为(14±2.6)d。治疗组的住院天数为(20.5±4.2)d,明显短于对照组的(27.4±3.6)d,但治疗组的住院费用明显多于对照组,差异有统计学意义(P<0.05)。治疗组经治疗后的总有效率(95.16%)明显高于对照组(58.82%),差异有统计学意义(P<0.05)。结论感染性压疮或皮肤溃疡患者应用闭式滴注灌洗结合VSD可以有效清除创伤面上的分泌物、坏死组织结构以及腔隙,治疗效果显著,建议广泛应用。

Objective To investigate the clinical effect of closed drip lavage combined with vacuum sealing drainage(VSD)in the treatment of infectious pressure sores or skin ulcers.Methods From July 2016 to June 2018,96 patients with pressure ulcers or post-traumatic skin ulcers(not included in diabetes)admitted to our hospital(including the General Hospital)were enrolled.According to the willingness to participate in this research project,they were divided into the control group(34 cases)and the treatment group(62 cases).In the control group,wound clearance using traditional dressing change was used,while in treatment group,closed drip lavage and VSD treatment was added on the basis of the control group.The clinical indicators were compared in the two groups.Results The infection control time was(13.1±4.5)d in the treatment group,which was significantly lower than that in the control group([21.4±5.2]d)(P<0.05).In the treatment group,wound skin grafting was performed(10.0±0.8)d after the fresh ulcer wound drainage,and the rest of the wound lasted for(14.5±2.5)d.In some cases,dressing change continued to wound healing.The average wound surface qualified for the skin grafting was(14±2.6)d.The hospital stay in the treatment group was(20.5±4.2)d,which was shorter than that in the control group([27.4±3.6]d),the hospitalization cost of the treatment roup was more than that in the control group,with significant difference(P<0.05).The total effectiveness rate of the treatment group after treatment was 95.16%,which was much lower than that of the control group accounting for 58.82%,with statistical difference(P<0.05).Conclusion For patients with infectious pressure sores or skin ulcers,closed drip lavage combined with VSD can effectively remove the secretions,necrotic tissue and cavity gap in the wound surface.The therapeutic effect is remarkable and is recommended to be widely used.