急诊治疗中负压封闭引流术对四肢软组织严重创伤患者的临床疗效观察

Observation of clinical Efficacy of Vacuum Sealing Drainage in treatment of severe soft tissue Trauma of Extremities

目的探讨在急诊治疗中负压封闭引流术(VSD)对四肢软组织严重创伤患者的治疗效果。方法对汝阳县人民医院急诊收治的108例四肢软组织严重创伤患者展开研究,资料收集时间在2019年5月至2021年5月,采用随机数字表法分为对照组和试验组,各54例。其中对照组给予常规清创引流治疗,试验组采用VSD治疗,比较两组手术时间、换药次数、创面愈合的时间和住院总时长等各项临床指标间的差异,并比较两组患者治疗前和治疗5d后炎性因子水平[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)]差异和创面面积的大小,评价患者治疗效果和安全性。结果试验组手术时间、创面愈合时间和住院总时长均短于对照组,换药次数少于对照组,差异有统计学意义(P<0.05)。两组治疗前炎性因子水平比较,差异无统计学意义(P>0.05);治疗后,两组IL-6、TNF-α和CRP水平均低于同组治疗前,差异有统计学意义(P<0.05);且试验组治疗后IL-6、TNF-α和CRP水平均低于对照组,差异有统计学意义(P<0.05)。两组治疗前创面面积比较,差异无统计学意义(P>0.05);治疗后,两组创面面积较同组治疗前相比均明显缩小,差异有统计学意义(P<0.05);且试验组治疗后创面面积小于对照组,差异有统计学意义(P<0.05)。试验组治疗有效率90.74%高于对照组75.93%,差异有统计学意义(P<0.05)。试验组并发症发生率5.56%低于对照组22.22%,差异有统计学意义(P<0.05)。结论VSD治疗四肢软组织严重创伤患者可以有效减轻机体的炎性因子水平,促进创面快速愈合,在减少并发症的同时提高患者的治疗效果,临床治疗的安全性和有效性较高,值得应用。

Objective To investigate the effect of vacuum sealing drainage(VSD)in the treatment of severe soft tissue trauma of extremities.Methods A total of 108 patients with severe soft tissue trauma of the extremities admitted to the Emergency Department of Ruyang County People's hospital from May 2019 to May 2019 were enrolled in the study,they were divided into control group(N=54)and experimental group(N=54)according to the random number table.The control group was treated with conventional debridement and drainage,and the experimental group was treated with VSD.The differences of clinical indexes such as operation time,times of dressing change,wound healing time and total length of hospital stay between the two groups were compared,the levels of inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)]and the size of wound area were compared between the two groups before and 5 days after treatment,the efficacy and safety of treatment were evaluated.Results The operation time,wound healing time and total length of hospital stay in the experimental group were shorter than those in the control group,and the times of dressing change were less than those in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the levels of inflammatory factors between the two groups before treatment(P>0.05),after treatment,the levels of IL-6,TNF-αand CRP in the two groups were lower than those before treatment,and the difference was significant(P<0.05),and the levels of IL-6,TNF-αand CRP in the experimental group were significantly lower than those in the control group after treatment(P<0.05).There was no significant difference in the wound area between the two groups before treatment(P>0.05),but after treatment,the wound area of the two groups was significantly smaller than that before treatment(P<0.05),and the wound area of the experimental group was smaller than that of the control group after treatment,the difference was statistically significant(P<0.05).The effective rate of the experimental group(90.74%)was significantly higher than that of the control group(75.93%)(P<0.05).The complication rate of the experimental group(5.56%)was lower than that of the control group(22.22%)(P<0.05).Conclusion VSD can effectively reduce the level of inflammatory factors in patients with severe soft tissue trauma of limbs,promote wound healing,reduce complications and improve the therapeutic effect,the safety and effectiveness of clinical treatment are high,so it is worth applying.