VSD联合中药苦劳汤灌洗对肛周坏死性筋膜炎患者预后的影响评价

The effect of VSD combined with traditional Chinese medicine Kulao Decoction lavage on the prognosis of perianal necrotizing fasciitis

目的评价负压闭式引流(VSD)技术联合中药苦劳汤灌洗治疗肛周坏死性筋膜炎的临床效果。方法52例肛周坏死性筋膜炎患者,随机分为观察组(27例)和对照组(25例)。观察组采用苦劳汤灌洗联合VSD引流,对照组采用手术切开引流管引流。观察比较两组不同时间段细菌检出率、菌落数、创面疼痛评分及伤口愈合时间、住院时间。结果观察组术后第7、14、20天的细菌检出率分别为14.81%、7.41%、3.70%,均明显低于对照组的40.00%、28.00%、24.00%,差异有统计学意义(P<0.05)。观察组术后第7、14、20天的菌落数分别为(4.32±0.67)、(3.96±0.75)、(1.27±0.63)cfu/cm2,明显低于对照组的(6.25±1.34)、(5.84±1.54)、(2.47±0.39)cfu/cm2,差异有统计学意义(P<0.05)。观察组术后第2、7、14天的疼痛评分显著低于对照组,差异有统计学意义(P<0.05)。观察组伤口愈合时间及住院时间均明显短于对照组,差异有统计学意义(P<0.05)。结论苦劳汤灌洗联合VSD引流治疗肛周坏死性筋膜炎可以有效抑制细菌生长,减轻患者的痛苦,促进伤口愈合,缩短住院时间,提高治愈率,值得临床推广。

Objective To evaluate the clinical effect of vacuum closed drainage(VSD)combined with traditional Chinese medicine Kulao Decoction lavage on the prognosis of perianal necrotizing fasciitis.Methods A total of 52 patients with perianal necrotizing fasciitis were randomly divided into observation group(27 cases)and control group(25 cases).the observation group was treated by Kulao Decoction lavage combined with VSD,and the control group was treated by incision drainage.The bacterial detection rate,number of bacterial colony,wound pain degree at different time points,wound pain score,wound healing time,hospitalization time were observed and compared between the two groups.Results 7,14 and 20 days after surgery,the bacterial detection rate of the observation group was 14.81%,7.41%and 3.70%respectively,which was obviously lower than that of the control group 40.00%,28.00%and 24.00%,and the difference was statistically significant(P<0.05).7,14 and 20 days after surgery,the number of bacterial colony of the observation group(4.32±0.67),(3.96±0.75)and(1.27±0.63)cfu/cm2,which was obviously lower than that of the control group(6.25±1.34),(5.84±1.54)and(2.47±0.39)cfu/cm2,and the difference was statistically significant(P<0.05).7,14 and 20 days after surgery,the pain score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The wound healing time and hospitalization time of the observation group was obviously shorter than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Kuluo Decoction lavage combined with VSD can effectively inhibit the growth of bacteria,reduce the pain of patients,promote wound healing,shorten hospitalization time,and improve the cure rate,which has a good clinical promotion value.