负压封闭引流技术在脊柱手术后皮下积液的应用

Application of Vacuum Sealing Drainage on Subcutaneous Effusion After Spinal Operation

目的探讨负压封闭引流技术(vacuum sealing drainage,VSD)治疗脊柱手术后皮下积液的临床疗效。方法2010年11月至2012年11月,我科采用VSD治疗脊柱手术后皮下积液患者26例(A组),选取同期接受传统换药治疗的23例患者为对照组(B组)。比较两组患者的再次手术率、换药次数、切口愈合时间、对患者影响程度、满意度及医疗费用。结果所有病例伤口愈合出院,随访3月无复发。A组再次手术率为19.23%(5/26),与B组(47.83%,11/23)比较差异有统计学意义(=4.538,P=0.033);A组换药次数、切口愈合时间、对患者影响程度分别为(4.77±2.20)次、(12.88±2.80)d、(1.23±0.86)分,与B组(12.70±1.36)次、(17.87±1.71)d、(2.17±0.65)分比较差异均有统计学意义(t=-14.939、t=-7.386、t=-4.275,P=0.000)。疗效满意度评价分"满意、合格、不满意",A组分别为20例、4例、2例,与B组(10例、5例、8例)比较差异有统计学意义(=6.887,P=0.032)。A组中再手术组、非手术组费用分别为(7504.20±130.34)、(2738.05±96.71)元,与B组(4741.18±153.98)元、(2014.08±109.64)元比较差异均有统计学意义(t=34.704、t=19.713,P=0.000)。结论 VSD治疗脊柱术后皮下积液效果良好,相比传统方法具有痛苦少、满意度高、工作量少等优点,能有效减少医疗纠纷。

Objective To discuss the clinical effects of vacuum sealing drainage on subcutaneous effusion after spinal operation. Methods From November 2010 to November 2012,26 cases of subcutaneous effusion after spinal operation were treated by vacuum sealing drainage( group A),23 cases were treated by traditional method during the same period were selected as control group( group B). Comparing the operation rate,frequency of change dressings,wound healing time,influence degree,satisfaction and medical expenses between group A and group B. Results All cases were followed up for 3 months,All wounds achieved primary healing postoperatively,and without recurrence. The operation rate was 19. 23% in group A and 47. 83% in group B,showing statistically significant difference( = 4. 538,P = 0. 033). The frequency of change dressings,wound healing time and influence degree in group A were( 4. 77 ± 2. 20),( 12. 88 ± 2. 80),( 1. 23 ± 0. 86),and( 12. 70 ± 1. 36),( 17. 87 ± 1. 71),( 2. 17 ±0. 65) in group B,showing statistically significant difference( t =- 14. 939,t =- 7. 386,t =- 4. 275,P = 0. 000). The evaluation results were Satisfied,qualified and dissatisfied. There were 20 cases,4cases,2cases in group A,and 10 cases,5cases,8cases in group B,showing statistically significant difference( = 6. 887,P = 0. 032). The medical expenses of operation group and non operation group in group A were( 7504. 20 ± 130. 34),( 2738. 05 ± 96. 71),and( 4741. 18 ± 153. 98),( 2014. 08 ± 109. 64) in group B,showing statistically significant difference( t = 34. 704,t = 19. 713,P = 0. 000). Conclusion The clinical effects of vacuum sealing drainage on subcutaneous effusion after spinal operation were good. Vacuum sealing drainage has more merits than traditional method: less pain,more satisfaction,less workload,and can reduce medical disputes.