负压封闭引流技术联合医用几丁糖治疗骨筋膜室综合征临床疗效观察

Clinical effect of VSD combined with chitosan for treatment of osteofascial compartment syndrome

①目的探讨负压封闭引流(VSD)技术联合医用几丁糖治疗骨筋膜室综合征(OCS)的临床疗效,为OCS切开减压后的治疗提供更加合理有效的方案。②方法选取2016年12月~2018年12月就诊于唐山工人医院的OCS患者52例作为研究对象,分为对照组和观察组,各26例。所有患者入院后对筋膜室行切开减压。对照组采用VSD治疗方案,观察组采用VSD联合医用几丁糖治疗方案,即在VSD装置上的进水管每日固定时间输入医用几丁糖30mL,在治疗7天后拆除VSD装置,对比两组治疗后的效果。③结果观察组肉芽组织生长评分明显高于对照组,创面感染率、患肢消肿时间、观察组的创面愈合时间及住院时间明显低于对照组。④结论采用VSD技术联合医用几丁糖是治疗OCS的有效方法之一,在促进创面肉芽组织生长及缩短患肢消肿时间、创面愈合时间、住院时间、降低创面感染率等方面相较对照组有显著提高,值得临床借鉴和推广应用。

Objective To explore the clinical effect of VSD combined with chitosan for the treatment of osteofascial compartment syndrome,and to provide a more reasonable and effective solution for the treatment of compartment syndrome after decompression.Methods Selected from December 2016 to December 2018 in Tangshan Gongren Hospital during the period of osteofascial compartment syndrome 52 patients as the research object,by randomly grouping method was divided into control group(n=26)and observation group(n=26).All patients admitted to hospital after the fascial compartment was decompressed by incision,the control group with VSD technique treatment,the observation group the VSD technique combined chitosan treatment scheme,which based on ordinary VSD of a water inlet pipe,and in the daily fixed time by the water inlet pipe injection of chitosan 30 mL,and chitosan in the treatment of 7 days after dismantling the VSD devices,open wounds,contrast the treatment effect of the two groups after treatment.Results Granulation tissue growth rating points in observation group was significantly higher than the control group,the observation group of wound infection rate,swelling elimination time days,wound healing time days and hospitalization time days significantly lower than the control group.Conclusion VSD technique combined chitosan is one of the effective method of treatment of osteofascial compartment syndrome,especially in the promote wound granulation tissue growth,shorten the swelling time,the healing time and hospital stay,reduce the infection of the wound rate compared with the control group there was a significant increase,worth clinical reference and popularization and application.