封闭负压引流联合银离子敷料在老年患者慢性难愈性创面修复中的应用效果

Application effect of vacuum sealing drainage combined with silver ion dressing on chronic refractory wound repair in elderly patients

目的分析封闭负压引流(VSD)联合银离子敷料在老年患者慢性难愈性创面修复中的应用效果。方法抽取2015年1月至2021年3月郑州市第九人民医院收治的慢性难愈性创面老年患者62例,年龄61~75岁,按照治疗方案分为两组。常规组31例采用常规治疗,联合组31例采用VSD联合银离子敷料治疗。比较两组疗效、恢复指标、创面面积改善率、肉芽成熟度、乳酸脱氢酶(LDH)、C-反应蛋白(CRP)。结果联合组总有效率为96.77%(30/31),高于常规组的70.97%(22/31),P<0.05。联合组肉芽长出时间、创面愈合时间、住院时间短于常规组(t=17.100、12.098、19.025,P<0.05)。治疗后3、7、21 d,联合组创面面积改善率高于常规组(t=4.746、12.606、18.966,P<0.05)。联合组肉芽成熟度Ⅳ度占比高于常规组(U=2.357,P=0.018)。治疗后,联合组LDH、CRP低于常规组(t=8.686、18.548,P<0.05)。结论VSD联合银离子敷料应用于老年患者慢性难愈性创面修复中效果良好,可改善组织缺氧和炎性状态,提高肉芽成熟度,加快创面恢复。

Objective To analyze the application effect of vacuum sealing drainage(VSD)combined with silver ion dressing on chronic refractory wound repair in elderly patients.Methods A total of 62 elderly patients with chronic refractory wounds who were admitted to Zhengzhou Ninth People’s Hospital from January 2015 to March 2021,aged 61 to 75 years,were divided into two groups according to the treatment plan.Thirty-one cases in the conventional group were treated with conventional treatment,and 31 cases in the combined group were treated with VSD combined with silver ion dressing.The curative efficacy,recovery indicators,wound area improvement rate,granulation maturity,lactate dehydrogenase(LDH),and C-reactive protein(CRP)were compared between the two groups.Results The total effective rate in the combined group was 96.77%(30/31),which was higher than 70.97%(22/31)in the conventional group,P<0.05.The granulation growth time,wound healing time and hospital stay in the combined group were shorter than those in the conventional group(t=17.100,12.098,19.025,P<0.05).At 3,7,and 21 days after treatment,the wound area improvement rate in the combined group was higher than that in the conventional group(t=4.746,12.606,18.966,P<0.05).The proportion of granulation maturityⅣdegree in the combined group was higher than that in the conventional group(U=2.357,P=0.018).After treatment,the LDH and CRP in the combined group were lower than those in the conventional group(t=8.686,18.548,P<0.05).Conclusions The application of VSD combined with silver ion dressing in the repair of chronic refractory wounds in the elderly patients has a good effect.It can improve tissue hypoxia and inflammatory state,increase granulation maturity,and accelerate wound recovery.