负压封闭引流技术治疗创伤性骨折创面软组织损伤的临床效果

Clinical effect of vacuum sealing drainage technology for traumatic fracture wound soft tissue injury

目的探讨负压封闭引流技术(VSD)治疗创伤性骨折创面软组织损伤的临床效果.方法选取三明市第二医院急诊外科2016年6月-2018年6月收治的创伤性骨折创面软组织损伤患者160例,按照治疗方法分为对照组与观察组,各80例.对照组患者给予传统局部换药治疗,观察组患者采用VSD治疗.比较两组患者临床效果、住院时间、抗生素使用时间、二期手术闭合创面时间、创面面积、敷料更换次数、治疗前后炎性因子[超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞计数(WBC)]水平,并观察两组患者治疗期间并发症发生情况.结果观察组患者总有效率高于对照组,住院时间、抗生素使用时间、二期手术闭合创面时间短于对照组,创面面积小于对照组,敷料更换次数少于对照组(P<0.05).治疗前两组患者hs-CRP、PCT、WBC水平比较,差异无统计学差异(P>0.05);治疗后观察组患者hs-CRP、PCT、WBC水平低于对照组(P<0.05).观察组患者并发症发生率低于对照组(P<0.05).结论 VSD治疗创伤性骨折创面软组织损伤的临床效果确切,可改善患者临床症状及体征,促进疾病恢复,减轻炎性反应,且安全性较高.

Objective To investigate the clinical effect of VSD technology for traumatic fracture wound soft tissue injury.Methods A total of 160 cases of patients with traumatic fracture wound soft tissue injury were selected from June 2016 to June 2018 in the Department of Emergency Surgery,the Second Hospital of Sanming City,which were divided into control group and observation group according to the treatment method,80 cases in each group.The control group were treated with traditional local dressing change,while the observation group were treated with VSD technology.The clinical efficacy,hospitalization time,antibiotic use time,wound closure time in the second stage operation,wound area and the times of dressing replacement were compared between the two groups.The levels of inflammatory factors including hs-CRP,PCT and WBC before and after treatment were compared between the two groups,and the complications during treatment were observed.Results The observation group of the total effective rate was higher than control group,the hospitalization time,antibiotic use time and wound closure time in the second stage operation were shorter than control group,the wound area was smaller than control group,and the times of dressing replacement were less than control group(P<0.05).There was no significant differences in hs-CRP,PCT or WBC levels between the two groups before treatment(P>0.05);after treatment,the observation group of the levels of hs-CRP,PCT and WBC were lower than control group(P<0.05).The incidence rate of complications in the observation group was lower than control group(P<0.05).Conclusion VSD has a good clinical effect for traumatic fracture wound soft tissue injury,which can improve clinical symptoms and signs,promote disease recovery,alleviate inflammatory reaction,and with high safety.