骨外露创面扩创术修复后负压封闭引流联合局部氧疗的疗效及预后分析

Analysis of the efficacy and safety of vacuum sealing drainage combined with local oxygen therapy in the treatment of wounds with exposed bone after debridement

目的探讨骨外露创面扩创术修复后给予负压封闭引流(VSD)联合局部氧疗的疗效及预后。方法选取2017年1月—2018年1月徐州市第一人民医院收治的88例行骨外露创面扩创修复术患者。按随机数字法分为VSD+氧疗组和机械治疗组。VSD+氧疗组行VSD联合局部氧疗,机械治疗组行传统清创联合换药方式治疗。比较两组创面愈合情况、临床治疗指标、创口微环境检测指标及不良反应情况。结果VSD+氧疗组临床基本愈合率较机械治疗组高(P<0.05)。VSD+氧疗组换药次数、完全愈合时间及住院时间较机械治疗组低(P<0.05)。两组渗液酸碱度、伤口温度及C反应蛋白比较,差异有统计学意义(P<0.05)。VSD+氧疗组不良反应率较机械治疗组低(P<0.05)。结论骨外露创面扩创术修复后给予VSD联合局部氧疗,能够改善创面愈合效果,改善创口微环境,提升临床治愈率和安全性。

Objective To evaluate the efficacy and safety of vacuum sealing drainage(VSD)combined with local oxygen therapy in the treatment of wounds with exposed bone after debridement.Methods A total of 88 patients with wounds with exposed bone treated in our hospital from January 2017 to January 2018 were randomly divided into VSD+oxygen therapy group(46 cases)and mechanical treatment group(42 cases).The VSD+oxygen therapy group was treated with VSD combined with local oxygen therapy,and mechanical treatment group was treated with traditional debridement and dressing change.The wound healing,indicators of clinical treatment,clinical indicators of wound microenvironment and adverse reactions between the two groups were compared.Result The percentage of basic healing in VSD+oxygen therapy group was higher than that in mechanical treatment group(P<0.05).The frequency of dressing change in VSD+oxygen therapy group was less than that in mechanical treatment group,and the complete healing time and hospitalization duration of VSD+oxygen therapy group were shorter than those of mechanical treatment group(P<0.05).Besides,the wound microenvironment indicated by pH value of exudates,wound temperature,and C-reactive protein(CRP)was different between VSD+oxygen therapy group and mechanical treatment group(P<0.05).Conclusion VSD combined with local oxygen therapy can promote wound healing,improve wound microenvironment,and enhance the clinical cure rate and safety in the treatment of wounds with exposed bone after debridement.