胶原酶促进开胸术后切口愈合的临床研究

Clinical study on collagenase in the promotion of wound healing after thoracotomy

目的分析胶原酶对经胸骨正中切口开胸术后切口难愈合患者创面的清创作用及其对愈合的促进作用。方法选择自2017年1月至2020年8月,沈阳友谊美容医院收治的30例经胸骨正中切口开胸术后切口不愈合的患者,根据是否应用胶原酶治疗,将患者分为传统治疗组和胶原酶治疗组,每组15例。记录患者年龄、性别、清创后创面面积。统计对比分析两组患者的清创率、创面愈合时间、住院时间、疼痛程度及满意度。结果应用胶原酶后在3、7、14 d因胶原酶治疗组的清创率分别为21.56±0.70、30.05±0.78和62.30±1.94,均显著优于常规治疗组的16.58±0.44、22.71±0.42和52.35±1.74,组间比较差异均有统计学意义(P<0.05)。常规治疗组创面愈合时间也明显长于胶原酶治疗组(P<0.05)。传统治疗组的平均住院时间显著长于胶原酶治疗组(P<0.05)。治疗3、7、14 d时,VAS评分显示,胶原酶治疗能够缓解常规治疗过程中的疼痛,组间比较其差异有统计学意义(P<0.05),胶原酶治疗组满意度明显高于常规治疗组。结论胶原酶治疗经胸骨正中切口开胸术后切口不愈合的患者,能够促进创面肉芽组织生长、加速愈合、降低疼痛程度,提高了患者满意度。

Objective To analyze the debridement and promotion of collagenase on wounds in patients after thoracotomy through median sternotomy approach.Methods From January 2017 to August 2020,30 patients with nonunion of incision after thoracotomy admitted in Friendship Cosmetic Plastic Surgery Hospital.All patients were divided into routine treatment group and collagenase treatment group,15 patients in each group.The age,gender and area of wounds after debridement were recorded.The rate of debridement,wound healing time,length of stay,pain degree and satisfaction of both groups were statistically analyzed.Results The rate of debridement of collagenase treatment group was 21.56±0.70,30.05±0.78 and 62.30±1.94 at 3,7 and 14 days,which were significantly better than 16.58±0.44,22.71±0.42 and 52.35±1.74 of routine treatment group.The differences were statistically significant between both groups(P<0.05).The wound healing time of routine treatment group was significantly longer than that of collagenase treatment group(P<0.05).The average length of stay of routine treatment group was significantly longer than that of collagenase treatment group(P<0.05).At 3,7 and 14 days,the VAS score showed that collagenase treatment could relieve pain in the process of routine treatment.The differences were statistically significant between both groups(P<0.05).The satisfaction of collagenase treatment group was obviously higher than that of routine treatment group.Conclusion Collagenase can promote granulation tissue growth of wounds,accelerate healing,reduce pain and improve patients'satisfaction in the treatment of nonunion of incision after thoracotomy through median sternotomy approach.