中华损伤与修复杂志（电子版）
中華損傷與脩複雜誌（電子版）
중화손상여수복잡지（전자판）
Chinese Journal of Injury Repair and Wound Healing
2014年
2期
162-165
,共4页
马任远%王小林%张哲%李冠雄%杨中民
馬任遠%王小林%張哲%李冠雄%楊中民
마임원%왕소림%장철%리관웅%양중민
烧伤%负压封闭引流%皮肤移植
燒傷%負壓封閉引流%皮膚移植
소상%부압봉폐인류%피부이식
Burns%Vacuum sealing drainage%Skin transplantation
目的：探讨负压封闭引流技术（VSD）联合植皮术在深度烧伤创面修复中的临床应用价值。方法回顾性分析2010年2月至2012年12月榆林市第二医院收治的深Ⅱ度、Ⅲ度烧伤患者共50例，根据治疗方法不同分为两组：治疗组26例，植皮前后分别采用VSD治疗促进创面愈合；对照组24例，采用传统常规换药方法，肉芽组织新鲜后植皮，加压包扎植皮区。观察两组中并发症发生率、首次植皮存活率、创面感染率、住院时间、总医疗费用等差异。结果治疗组和对照组并发症发生率分别为3．85％和12．50％，两组比较差异有统计学意义（P＜0．05），两组中细菌培养阳性率分别为7．69％和41．67％，两组比较差异有统计学意义（χ2＝7．898，P＜0．05），首次植皮存活率分别为96．15％和70．83％，两组比较差异有统计学意义（χ2＝5．953，P＜0．05）；两组疼痛评分分别为（4．15±1．29）分和（6．24±2．01）分，差异有统计学意义（t ＝4．336，P＜0．05）；住院时间分别为（21．4±4．5）d和（30．8±6．7）d，两组比较差异有统计学意义（t＝5．775，P＜0．05）；两组总医疗费用分别为（34960．4±8949．2）元和（29512．8±6749．7）元，差异无统计学意义（t＝2．414，P＞0．05）。结论 VSD使用安全、简便，可有效促进烧伤创面的愈合，降低创面感染率，减轻患者痛苦，提高植皮存活率，缩短住院时间，值得临床推广应用。
目的：探討負壓封閉引流技術（VSD）聯閤植皮術在深度燒傷創麵脩複中的臨床應用價值。方法迴顧性分析2010年2月至2012年12月榆林市第二醫院收治的深Ⅱ度、Ⅲ度燒傷患者共50例，根據治療方法不同分為兩組：治療組26例，植皮前後分彆採用VSD治療促進創麵愈閤；對照組24例，採用傳統常規換藥方法，肉芽組織新鮮後植皮，加壓包扎植皮區。觀察兩組中併髮癥髮生率、首次植皮存活率、創麵感染率、住院時間、總醫療費用等差異。結果治療組和對照組併髮癥髮生率分彆為3．85％和12．50％，兩組比較差異有統計學意義（P＜0．05），兩組中細菌培養暘性率分彆為7．69％和41．67％，兩組比較差異有統計學意義（χ2＝7．898，P＜0．05），首次植皮存活率分彆為96．15％和70．83％，兩組比較差異有統計學意義（χ2＝5．953，P＜0．05）；兩組疼痛評分分彆為（4．15±1．29）分和（6．24±2．01）分，差異有統計學意義（t ＝4．336，P＜0．05）；住院時間分彆為（21．4±4．5）d和（30．8±6．7）d，兩組比較差異有統計學意義（t＝5．775，P＜0．05）；兩組總醫療費用分彆為（34960．4±8949．2）元和（29512．8±6749．7）元，差異無統計學意義（t＝2．414，P＞0．05）。結論 VSD使用安全、簡便，可有效促進燒傷創麵的愈閤，降低創麵感染率，減輕患者痛苦，提高植皮存活率，縮短住院時間，值得臨床推廣應用。
목적：탐토부압봉폐인류기술（VSD）연합식피술재심도소상창면수복중적림상응용개치。방법회고성분석2010년2월지2012년12월유림시제이의원수치적심Ⅱ도、Ⅲ도소상환자공50례，근거치료방법불동분위량조：치료조26례，식피전후분별채용VSD치료촉진창면유합；대조조24례，채용전통상규환약방법，육아조직신선후식피，가압포찰식피구。관찰량조중병발증발생솔、수차식피존활솔、창면감염솔、주원시간、총의료비용등차이。결과치료조화대조조병발증발생솔분별위3．85％화12．50％，량조비교차이유통계학의의（P＜0．05），량조중세균배양양성솔분별위7．69％화41．67％，량조비교차이유통계학의의（χ2＝7．898，P＜0．05），수차식피존활솔분별위96．15％화70．83％，량조비교차이유통계학의의（χ2＝5．953，P＜0．05）；량조동통평분분별위（4．15±1．29）분화（6．24±2．01）분，차이유통계학의의（t ＝4．336，P＜0．05）；주원시간분별위（21．4±4．5）d화（30．8±6．7）d，량조비교차이유통계학의의（t＝5．775，P＜0．05）；량조총의료비용분별위（34960．4±8949．2）원화（29512．8±6749．7）원，차이무통계학의의（t＝2．414，P＞0．05）。결론 VSD사용안전、간편，가유효촉진소상창면적유합，강저창면감염솔，감경환자통고，제고식피존활솔，축단주원시간，치득림상추엄응용。
Objective To investigate the clinical therapeutic effect of the vacuum-sealing drainage(VSD)combining with skin graft in a deep burn wound.Methods From February 2010 to December2012,50 patients of deep burns were treated in the Second Hospital of Yulin City.They were divided intotwo groups according to treatment method.Twenty-six patients were assigned as the VSD treatment group,which was treated by VSD before and after skin transplantation.Twenty-four patients were assigned as theroutine treatment group,which was treated by regular dressing change.Their wounds were transplanted bythe split thickness skins binding up by packing when they were fitted.The results in terms of complications,the positive rate of bacterial culture of wound,the survival rate of first time skin grafting,pain score,thehospital length of stay and the cost of treatment were compared between the two groups.Results Theincidence rate of complication in VSD group were obviously less than those of routine treatment group (3.85% vs.12.50%,P <0.05).There were obvious differences between the two groups in followingindices:the positive rate of bacterial culture (7.69% vs.41.67%,P <0.05),the survival rate of skingrafting (96.15% vs.70.83%,P <0.05),pain score(4.15 ±1.29 vs.6.24 ±2.01,P <0.05),thehospital length of stay(21.4 ±4.5 d vs.30.8 ±6.7 d,P <0.05).There was no significant differencebetween the two groups in the cost of treatment (34960.4 ±8949.2 vs.29512.8 ±6749.7,P >0.05).Conclusions The VSD provides a convenient and effective method for treating depth burn wound,which canreduce the positive rate of bacterial culture of wound,reduce the pain of patients,increase the survival rateof skin grafts,shorten the hospital length of stay.It is worth being widely applied in clinical practice.
