水凝胶敷料与负压封闭引流技术联用在四肢开放性骨折患者中的应用效果

Application effect of hydrogel dressing with vacuum sealing drainage technique in patients with open fractures of extremities

目的探讨水凝胶敷料与负压封闭引流(VSD)技术在四肢开放性骨折(OFOE)患者中的应用效果及对患者术后创面愈合情况、白介素-4(IL-4)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平的影响。方法选取2018年5月至2020年3月沈阳积水潭医院收治的100例OFOE患者作为研究对象,采用随机数字表法将其分成对照组(50例)和观察组(50例)。对照组患者采用VSD技术进行治疗,观察组患者在对照组的基础上加用水凝胶敷料进行治疗。比较两组患者的术后创面愈合效果、IL-4、IL-10、TNF-α水平以及临床疗效。结果观察组患者的换药次数少于对照组,伤口恢复时间短于对照组,皮瓣形成率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的IL-4、IL-10、TNF-α水平比较,差异无统计学意义(P>0.05)。两组患者治疗后的IL-4、IL-10、TNF-α水平低于治疗前,且观察组患者治疗后的IL-4、IL-10、TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。观察组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论OFOE患者联合应用功能水凝胶敷料和VSD技术进行治疗,其术后创面愈合的效果较好,还可改善IL-4、IL-10、TNF-α水平,值得推广。

Objective To explore the application effect of hydrogel dressing and vacuum sealing drainage(VSD)technique in patients with open fractures of extremities(OFOE)and the effect on postoperative wound healing,interleukin-4(IL-4),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)levels.Methods A total of 100 OFOE patients admitted to Shenyang Jishuitan Hospital from May 2018 to March 2020 were selected as research subjects and divided into control group(50 cases)and observation group(50 cases)by random number table method.Patients in the control group were treated with VSD technology,and patients in the observation group were treated with hydrogel dressing on the basis of the control group.The postoperative wound healing effect,levels of IL-4,IL-10,TNF-α and clinical efficacy were compared between the two groups.Results The frequency of dressing change in the observation group was less than that in the control group,the wound recovery time was shorter than that in the control group,and the flap formation rate was higher than that in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of IL-4,IL-10 and TNF-α between the two groups(P>0.05).The levels of IL-4,IL-10 and TNF-α in the two groups after treatment were lower than those before treatment,and the levels of IL-4,IL-10 and TNF-α in the observation group after treatment were lower than those in the control group,and the differences were statistically significant(P<0.05).The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Combining functional hydrogel dressing and VSD technology in OFOE patients can improve IL-4,IL-10 and TNF-α levels,which is worth promotion.