覆盖式封闭引流技术(VSD)治疗眼镜蛇咬伤后肢体肿胀及溃疡的临床研究

Clinical study of overlying VSD in treatment of skin swelling and ulceration after cobra bites

目的探讨覆盖式封闭引流技术(VSD)治疗眼镜蛇咬伤后肢体肿胀及溃疡的效果。方法选取2019年6月至2023年4月我院收治的85例眼镜蛇咬伤患者为研究对象,随机分为VSD治疗组(n=45)和对照组(n=40)。VSD治疗组采取覆盖式VSD对眼镜蛇咬伤创面进行处理,对照组采取常规创面引流处理,两组均给予常规换药、抗感染及对症支持治疗。观察两组患者治疗前后咬伤部位肢体肿胀及创面溃疡情况、疼痛水平、炎症指标,并比较创面溃疡愈合时间及临床疗效。结果治疗7 d后,VSD治疗组的创面溃疡面积、肿胀评分、VAS评分及溃疡愈合时间改善均优于对照组,组间比较差异均有统计学意义(均P<0.001)。治疗7 d后,两组患者的炎症因子指标水平均较治疗前下降,而且VSD治疗组的WBC、CK、Mb、AST、CRP指标水平降低优于对照组,差异均有统计学意义(均P<0.001)。两组患者的治疗效果比较,VSD治疗组的总有效率为93.33%,对照组的总有效率为77.50%,差异有统计学意义(χ2=4.379,P=0.036)。结论覆盖式VSD治疗眼镜蛇咬伤后肢体肿胀及溃疡的效果明显,可有效控制炎症反应,对促进消肿及溃疡愈合有积极的作用。

Objective To investigate the short to medium-term efficacy of the overlay VSD technique in the treatment of skin swelling and ulceration after cobra bite.Methods Selected 85 cases of cobra bite patients admitted in our hospital from June 2019 to April 2023 as the study object,divided into VSD treatment group(n=45)and control group(n=40)by simple randomization grouping.The VSD treatment group adopts covered VSD for the treatment of trauma after cobra bite and the control group adopts the conventional trauma drainage treatment.Both groups were treated with routine dressing change,anti-infection and symptomatic support.Comparison and analysis of two groups of patients before and after the treatment of wound swelling and ulceration,pain level,inflammation indicators and coagulation function,wound healing time,and so on.Results After 7 days of treatment,the improvement of wound ulcer area,swelling score,VAS score and ulcer healing time in the VSD group was better than that in the control group,with statistical significance between groups(all P<0.001).After 7 days of treatment,the levels of inflammatory factors in 2 groups were lower than before treatment,and the levels of WBC,CK,Mb,AST and CRP in VSD group were lower than those in control group,with statistical significance(all P<0.001).The total effective rate of the VSD group was 93.33%and that of the control group was 77.50%,the difference was statistically significant(χ2=4.379,P=0.036).Conclusion Covering VSD is effective in the treatment of limb swelling and ulcer after cobra bite.It can effectively control the inflammatory response,and has a positive effect on promoting the reduction of swelling and ulcer healing.