复杂创面患者双管型VSD术后抗生素应用效果分析

Antibiotic application after double-tube VSD for patients with complex wound

目的探讨双管型VSD 技术治疗不同部位复杂创面的临床疗效。方法 选取2017 年10月至2018 年3 月本院收治的复杂创面患者100 例作为研究组,同时选取同期本院采用传统创伤处理技术的100 例患者作为对照组,研究对比两组患者堵管率、抗生素使用时间以及处方更换次数等指标的差异。结果 研究组和对照组患者软组织缺损或创伤、腹部创面、烫烧伤、放射性创面、胸骨创面肉芽恢复良好例数分别为25、12、13、15、15 例以及12、3、4、5、5 例,研究组患者各个复杂创面肉眼恢复情况优于对照组(P < 0.05);研究组和对照组感染率、堵管率、抗生素使用时间分别为5.0%、5.0%、(14.3±2.2)d 和15.0%、14.0%、(21.2±2.3)d;经治疗后两组患者感染率以及堵管率比较差异均有统计学意义(均P < 0.05),研究组抗生素使用时间显著短于对照组(P < 0.05),和更换处方数显著少于对照组(P < 0.05)。结论 应用VSD 对患者复杂创面进行治疗,可显著减少抗生素使用时间,同时该技术应在规定的负压范围内,考虑到不同人群以及患者不同体质的差异视患者实际情况对负压进行适当的调整,过低或者过高的负压均不利于患者创面的恢复。

Objective To explore the clinical effect of sdouble-tube VSD for patients with complex wound on different sites. Methods 100 patients with complex wound admitted to our hospital from October, 2017 to March, 2018 were selected as a study group, and 100 patients treated with traditional trauma treatment technology at our hospital during the same period were selected as a control group. And the plugging rate, antibiotic use time, and number of times of prescription change were compared between the two groups. Results The case numbers of good recovery of soft tissue defect or trauma, abdominal wound, hot burn, radioactive wound, and sternum wound granulation were 25, 12, 13, 15, and 15 in the study group, and were 12, 3, 4, 5 and 5in the control group (all P < 0.05). The infection rate, plugging rate, and antibiotic use time were 5.0%, 5.0%, and (14.3±2.2) d in the study group, and were 15.0%, 14.0%, and (21.2±2.3) d (all P < 0.05). The number of prescriptions was significantly lower in the study group than in the control group (P < 0.05). Conclusion VSD in the treatment of patients with complex wounds can significantly reduce the time of using antibiotics. The technology should be within the prescribed negative pressure range;the negative pressure should be appropriately adjusted according to the actual situation of peoples and patients with physical differences. A too low or too high negative pressure is not conducive to wound recovery.