芒硝溶液持续滴注结合负压封闭引流技术（VSD）治疗腹部感染性伤口的应用研究

Application study of continuous infusion of glauconite solution combined with vacuum sealing drainage (VSD) in the treatment of infected abdominal wounds

目的为促进腹部感染性伤口的恢复,降低伤口耐药的发生率,在负压封闭引流技术(VSD)的基础上持续滴注芒硝溶液,与传统生理盐水滴注对比并评估其疗效,为治疗腹部手术部位感染提供更加有效经济的新方法。方法收集2018年1月至2018年12月南昌大学第二附属医院胃肠外科和中山大学附属第六医院胃肠、疝和腹壁外科收治的腹会阴部手术后出现伤口感染且较难愈合,伤口清创后予以负压封闭引流术的80例患者。随机将其分为两组,试验组40例,持续滴注芒硝溶液结合负压封闭引流技术,对照组40例,持续滴注生理盐水结合负压封闭引流技术,观察比较两组患者清创后创面新鲜肉芽覆盖情况、术后疼痛缓解情况、伤口达二期缝合时间、伤口缝合后愈合时间、换药总费用等。结果在相同时间内试验组患者的创面肉芽组织生长情况评分为(3.97±0.42),明显好于对照组(2.25±0.44),伤口达二期愈合时间为(11.75±1.69 d),明显短于对照组(16.4±2.74 d);试验组患者手术后疼痛评分为(2.87±0.36),明显低于对照组(4.05±0.85);试验组患者伤口缝合后愈合时间为(7.15±1.63)天较对照组(10.27±2.89)天明显缩短;试验组患者换药次数及费用明显低于对照组,以上差异均有统计学意义(P<0.05)。结论持续滴注芒硝溶液结合负压封闭引流技术可以显著促进腹部感染性伤口的快速恢复,减轻患者负担,节约医疗资源,为临床治疗腹部感染性伤口提供更加经济有效的方案。

Objective In order to promote the healing of infectious abdominal wounds and reduce the incidence of drug resistance,continuous drip infusion of glauconite solution on the basis of negative pressure closed drainage technique(VSD) was conducted to compare with traditional normal saline drip and evaluate its efficacy,so as to provide a more effective and economical new method for the treatment of abdominal surgical site infection.Methods From January 2018 to December 2018,80 patients who underwent negative pressure closure and drainage after wound debridement were collected from the department of general surgery of the second affiliated hospital of nanchang university and the department of gastrointestinal and hernia surgery,the Sixth Affiliated Hospital of Sun Yat-sen University.It can be divided into two groups at random,the experimental group 40 cases,continuous drip mirabilite solution with closed negative pressure drainage technology,the control group,40 cases of continuous drip saline combined with closed negative pressure drainage technology,compare two groups of patients with wound granulation tissue growth after debridement,improve postoperative pain,wound up to second stage suture time,wound healing after suture time,treatment cost,etc.Results The score of wound granulation tissue growth in the experimental group was(3.97±0.42),significantly better than the control group(2.25±0.44),and the wound healing time was(11.75±1.69)d,significantly shorter than the control group(16.4±2.74) d.The postoperative pain score of the experimental group was(2.87±0.36),which was significantly lower than that of the control group(4.05±0.85).The healing time of the experimental group was(7.15±1.63) d significantly shorter than that of the control group(10.27±2.89 d).The frequency and cost of dressing change in the experimental group were significantly lower than those in the control group,and the above differences were statistically significant(P<0.05).Conclusion Continuous drip of Glauber’s salt solution combined with negative pressure closed drainage technology can significantly promote the rapid recovery of abdominal infectious wounds,reduce the burden on patients,save medical resources,and provide a more cost-effective solution for clinical treatment of abdominal infectious wounds.