周康

【摘要】 目的：探討負壓封閉引流（VSD）技術(shù)治療四肢創(chuàng)傷軟組織缺損創(chuàng)面患者的效果。方法：選取2017年1月-2018年12月本院收治的四肢創(chuàng)傷軟組織缺損創(chuàng)面患者56例，根據(jù)臨床治療方法不同將其分為兩組，對照組進行常規(guī)方法治療，研究組進行VSD技術(shù)治療。比較兩組療效、植皮所需時間、住院時間、住院花費、植皮成活率、創(chuàng)面愈合率、滿意評分、換藥次數(shù)、創(chuàng)面達到清潔時間、并發(fā)癥。結(jié)果：研究組療效高于對照組，植皮所需時間、住院時間均短于對照組，住院花費少于對照組，植皮成活率、創(chuàng)面愈合率均高于對照組，滿意評分高于對照組，換藥次數(shù)少于對照組，創(chuàng)面達到清潔時間短于對照組，并發(fā)癥發(fā)生率低于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論：四肢創(chuàng)傷軟組織缺損創(chuàng)面治療中，VSD技術(shù)的療效顯著，值得應(yīng)用。

【關(guān)鍵詞】 負壓封閉引流技術(shù) 四肢 創(chuàng)傷軟組織缺損創(chuàng)面 植皮成活 創(chuàng)面愈合

[Abstract] Objective： To explore the effect of vacuum sealing drainage （VSD） in the treatment of traumatic soft tissue defects in limbs. Method： Fifty-six patients with traumatic soft tissue defects in limbs treated in our hospital from January 2017 to December 2018 were selected. They were divided into two groups according to different clinical treatment methods. The control group was treated with conventional methods， the study group was treated with VSD. The curative effect， skin grafting time， hospitalization time， hospitalization cost， skin grafting survival rate， wound healing rate， satisfaction score， dressing change times， wound cleaning time and complications of two groups were compared. Result： The total effective rate of the study group was higher than that of the control group， the time needed for skin grafting and hospitalization were shorter than those in the control group， the hospitalization cost was less than that in the control group， the survival rate of skin grafting and wound healing rate were higher than those in the control group， the satisfaction score was higher than that in the control group， the number of dressing changes in the study group was less than that in the control group， the cleaning time of the wounds was shorter than that in the control group， and the complications rate was lower than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： VSD is effective in the treatment of soft tissue defect of extremities and is worthy of application.

隨著我國社會的發(fā)展、經(jīng)濟的進步，各種器械與交通導(dǎo)致的意外傷也逐漸增多，四肢嚴重創(chuàng)傷的發(fā)生人數(shù)越來越多[1]。四肢創(chuàng)傷發(fā)生時一般會伴隨大面積皮膚缺損或者是軟組織挫傷，且如果不及時接受有效的治療容易導(dǎo)致創(chuàng)面感染。臨床上治療四肢創(chuàng)傷的常用方法為皮瓣移植覆蓋或換藥維持創(chuàng)面清潔，但是常規(guī)的方法需要的治療時間長，創(chuàng)面感染難以控制，且創(chuàng)面感染容易導(dǎo)致骨髓炎、骨感染、骨折不愈合等，嚴重的對患者的肢體功能恢復(fù)與保留均造成了影響[2]。因此，尋求更安全、有效的治療方法盡早對患者的肢體功能進行恢復(fù)與保留是非常重要的。近幾年，臨床上多采用負壓封閉引流（VSD）技術(shù)治療四肢創(chuàng)傷軟組織缺損創(chuàng)面，該方法可以有效促進創(chuàng)面愈合，減輕組織水腫，效果較好[3]。本院在四肢創(chuàng)傷軟組織缺損創(chuàng)面治療中，使用VSD技術(shù)進行治療，療效顯著，現(xiàn)報道如下。

1 資料與方法

1.1 一般資料 選取2017年1月-2018年12月本院收治的四肢創(chuàng)傷軟組織缺損創(chuàng)面患者56例。納入標準：（1）均符合四肢創(chuàng)傷軟組織缺損相關(guān)診斷標準;（2）溝通交流能力正常;（3）依從性較好。排除標準：（1）長期服用糖皮質(zhì)激素;（2）存在免疫系統(tǒng)疾病;（3）存在精神疾病;（4）存在嚴重的臟器疾病。根據(jù)臨床治療方法不同將其分為研究組與對照組，每組28例。該研究已經(jīng)倫理學(xué)委員會批準。