CAJ | 학술논문

目的通过与未行负压封闭引流(VSD)的创伤患者进行比较,探讨VSD减少创面愈合时毒素对机体再损伤的作用.方法回顾性分析2005年1月至2009年6月采用VSD治疗的32例患者(VSD组)和同期未行VSD治疗的37例患者(换药组)资料.两组性别比例、年龄、损伤部位、面积、合并伤及创伤时间等一般情况比较差异均无统计学意义(P＞0.05).比较两组患者治疗前和治疗后1周的体温、血常规、肝肾功能变化、创面治疗及愈合时间等,并对结果进行多因素线性回归分析.结果治疗前两组患者体温、血常规及肝肾功能指标的比较差异均无统计学意义(P＞0.05).治疗后5～7 d,VSD组与换药组的体温高于正常时间分别为(3.3±1.3)、(6.4±1.9)d,白细胞分别为(8.8±2.3)、(12.4±1.9)g/L,中性粒细胞分别为(6.3±2.4)、(9.2±2.7)g/L谷丙转氨酶分别为(41.1±30.0)、(58.9±34.5)U/L,谷草转氨酶分别为(38.0±24.7)U/L、(54.5±28.0)U/L,血肌酐分别为(94.8±23.7)、(118.6±23.5)μmol/L,伤口清创至植皮时间分别为(12.9±5.7)、(23.8±6.8)d,治疗时间分别为(26.5±12.5)、(36.7±13.2)d,创面愈合时间分别为(33.8±13.5)、(41.4±13.2)d,两组数据比较差异均有统计学意义(P＜0.05).结合各指标多因素分析及两组数据治疗前比较结果,治疗方式的不同是引起差异的主要因素.结论 VSD能促进创面毒素排出,减少毒素的再吸收和对机体的再损伤,促进创面愈合,缩短疗程.
목적 통과여미행부압봉폐인류(VSD)적창상환자진행비교,탐토VSD감소창면유합시독소대궤체재손상적작용.방법 회고성분석2005년1월지2009년6월채용VSD치료적32례환자(VSD조)화동기미행VSD치료적37례환자(환약조)자료.량조성별비례、년령、손상부위、면적、합병상급창상시간등일반정황비교차이균무통계학의의(P＞0.05).비교량조환자치료전화치료후1주적체온、혈상규、간신공능변화、창면치료급유합시간등,병대결과진행다인소선성회귀분석.결과 치료전량조환자체온、혈상규급간신공능지표적비교차이균무통계학의의(P＞0.05).치료후5～7 d,VSD조여환약조적체온고우정상시간분별위(3.3±1.3)、(6.4±1.9)d,백세포분별위(8.8±2.3)、(12.4±1.9)g/L,중성립세포분별위(6.3±2.4)、(9.2±2.7)g/L곡병전안매분별위(41.1±30.0)、(58.9±34.5)U/L,곡초전안매분별위(38.0±24.7)U/L、(54.5±28.0)U/L,혈기항분별위(94.8±23.7)、(118.6±23.5)μmol/L,상구청창지식피시간분별위(12.9±5.7)、(23.8±6.8)d,치료시간분별위(26.5±12.5)、(36.7±13.2)d,창면유합시간분별위(33.8±13.5)、(41.4±13.2)d,량조수거비교차이균유통계학의의(P＜0.05).결합각지표다인소분석급량조수거치료전비교결과,치료방식적불동시인기차이적주요인소.결론 VSD능촉진창면독소배출,감소독소적재흡수화대궤체적재손상,촉진창면유합,축단료정.
Objective To investigate the effect of vacuum sealing drainage (VSD) on wound healing by reducing re-injury to the tissue attributable to wound toxins. Methods A series of 32 patients with serious limb trauma were included in the present study who received VSD treatment in our department from January 2005 to June 2009. Another series of 37 patients of the same category were used as controls who received no VSD treatment but dressing instead at the same period. Exclusion criteria were liver and kidney diseases, diabetes mellitus, hypertension, serious organ disorders and major nerve and vascular injuries.There were no significant differences between the 2 groups in sex, age, site and size of injury, complications,time of trauma (P＞0.05). Body temperature and blood parameters (including results of hepatic and renal function tests) before and one week after the VSD treatment, wound management, and wound healing time were compared between the 2 groups, using multi-factor linear regression analysis. Results There were no significant differences between the 2 groups in body temperature and blood parameters ( P ＞ 0. 05 ) before treatment. But there were significant differences after treatment between the 2 groups in duration of high body temperature(3.3±1.3 days for the VSD group versus 6. 4 ± 1.9 days for the control group), white blood cells (8.8±2.3 g/L versus 12.4±1.9 g/L), neutrophil (6.3 ±2.4 g/L versus 9.2 ±2. 7 g/L), alanine aminotransferase (41.1±30.0 U/L versus 58.9 ±34. 5 U/L), aspartate aminotransferase (38.0±24.7 U/L versus 54.5±28.0 U/L), creatinine (94.8±23.7 μmol/L versus 118.6±23.5 μmol/L), wound debridement to skin grafting time (12.9±5.7 days versus 23.8±6.8 days), total treatment time (26.5 ± 12.5 days versus 36.7±13.2 days), wound healing time (33.8±13.5 days versus 41.4±13.2 days) ( P ＜0. 05 ＝. All the analyses showed the difference were attributable to VSD treatment. Conclusion VSD can facilitate wound healing and shorten therapeutic course by effectively removing wound toxins and thus reducing re-injury to the tissue.