复方黄柏液冲洗配合封闭负压引流设备治疗肛周坏死性筋膜炎30例

Treatment of 30 Cases of Perianal Necrotizing Fasciitis with Compound Phellocypress Solution and Vaccum Sealing Drainage Equipment

目的:观察复方黄柏液冲洗配合封闭负压引流设备治疗肛周坏死性筋膜炎的疗效。方法:将符合标准的60例符合纳入标准的肛周坏死性筋膜炎的患者随机分为观察组和对照组各30例,对照组术后予以常规每日换药,5%的双氧水冲洗创面;治疗组术后予以复方黄柏液冲洗配合封闭负压引流设备,比较2组患者术后清创换药次数、住院时间、住院费用、术前、术后第3天、术后第7天及术后第14天视觉模拟评分法(VisualAnalogueScaie/Score,VAS)评分和血清中碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)及转化生长因子-β1(transforming growth factor,TGF-β1)水平、术后2个月的创面愈合率等情况。结果:观察组术后清创换药次数、住院费用、术后VAS评分等方面均明显低于对照组(P<0.05),术后第7天及术后第14天血清中bFGF及TGF-β1水平、术后2个月的总有效率均高于对照组,差异具有统计学意义(P<0.05)。结论:复方黄柏液冲洗配合封闭负压引流设备可有效减少患者术后疼痛,促进创面早期愈合。

Objective:To observe the efficacy of irrigation with compound Phellodendron’s fluid combined with closed negative pressure drainage equipment in the treatment of perianal necrotizing fasciitis.Methods:a total of 60 patients with perianal necrotizing fasciitis fulfilling the inclusion criteria were randomly divided into observation and control groups of 30 patients each,and the control group was followed by routine daily dressing changes after surgery and wound irrigation with 5%dioxygen;The treatment group was washed with compound Phellodendron’s fluid combined with a closed negative pressure drainage device,and the number of debridement changes,length of hospital stay,hospital costs,visual analog scale(VAS)scores and serum levels of basic fibroblast growth factor(bFGF)and transforming growth factor(TGF-β)were compared between the 2 groups before operation,on postoperative day 3,on postoperative day 7,and on postoperative day 14-β1(transforming growth factor,TGF-β1)Level,and wound healing rate at 2 months postoperatively.Results:in the observation group,the number of postoperative debridement changes,hospital costs,and postoperative VAS scores were significantly lower than those of the control group(P<0.05),as were serum levels of bFGF and TGF on the 7th and 14th postoperative days-βLevel 1,the overall response rate at 2 months after surgery was higher than that of the control group,with statistically significant differences(P<0.05).Conclusions:combined Phellodendron fluid irrigation combined with closed negative pressure drainage equipment can effectively reduce postoperative pain and promote early wound healing in patients.