中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
39期
6392-6396
,共5页
买合木提·亚库甫%阿里木江·阿不来提%艾合买提江·玉素甫%杨广忠%许正利%李平
買閤木提·亞庫甫%阿裏木江·阿不來提%艾閤買提江·玉素甫%楊廣忠%許正利%李平
매합목제·아고보%아리목강·아불래제%애합매제강·옥소보%양엄충%허정리%리평
生物材料%骨生物材料%筋膜间室综合征%真空负压吸引%绑鞋带技术%下肢损伤%负压引流术%切开减压%伤口闭合%创伤
生物材料%骨生物材料%觔膜間室綜閤徵%真空負壓吸引%綁鞋帶技術%下肢損傷%負壓引流術%切開減壓%傷口閉閤%創傷
생물재료%골생물재료%근막간실종합정%진공부압흡인%방혜대기술%하지손상%부압인류술%절개감압%상구폐합%창상
drainage%leg bones%decompression%fascia
背景：目前认为负压吸引技术是治疗骨筋膜间室综合征切开减压切口较安全、有效的方法，但是治疗后创面往往不能自行闭合，需要植皮造成副损伤。有研究表明应用绑鞋带技术治疗小腿骨筋膜间室综合征减张切口取得良好的效果，但国内至今少有报道。目的：比较真空负压吸引技术与绑鞋带技术治疗小腿骨筋膜间室综合征切开减张切口的疗效。方法：将36例小腿骨筋膜室综合征患者患者(46个减张切口)随机分为负压吸引组和绑鞋带组，每组各23个减张切口，负压吸引组骨折复位后外固定架固定，切开减张后即行负压封闭引流治疗；绑鞋带组骨折患者复位后外固定架固定，切开减张治疗后创面敷贴负压封闭吸引材料-聚乙烯乙醇水化海藻盐泡沫，皮缘用皮肤吻合器作扣环采用硅橡胶袢充当缚带采用切口绑鞋带治疗技术。治疗后1个月比较两组患者切口大小、切口完全闭合切口所需时间、感染情况、需进一步干预的需求、日常治疗费用等情况。结果与结论：绑鞋带组切口闭合所需时间显著优于负压吸引组(P<0.05)。负压吸引组中有8个减张切口需行进一步植皮，绑鞋带组无需行植皮；绑鞋带组中5个减张切口需要更换硅橡胶袢。两组中创面感染率比较差异无显著性意义，也均未出现治疗后筋膜间室压力增高及皮缘坏死等现象。结果提示，真空负压吸引技术和绑鞋带技术均为治疗小腿骨筋膜间室综合征切开减张切口安全、有效的治疗技术，其疗效可靠，已被临床使用；与真空负压吸引技术相比，绑鞋带技术伤口闭合时间短、创伤小、疗效更优。
揹景：目前認為負壓吸引技術是治療骨觔膜間室綜閤徵切開減壓切口較安全、有效的方法，但是治療後創麵往往不能自行閉閤，需要植皮造成副損傷。有研究錶明應用綁鞋帶技術治療小腿骨觔膜間室綜閤徵減張切口取得良好的效果，但國內至今少有報道。目的：比較真空負壓吸引技術與綁鞋帶技術治療小腿骨觔膜間室綜閤徵切開減張切口的療效。方法：將36例小腿骨觔膜室綜閤徵患者患者(46箇減張切口)隨機分為負壓吸引組和綁鞋帶組，每組各23箇減張切口，負壓吸引組骨摺複位後外固定架固定，切開減張後即行負壓封閉引流治療；綁鞋帶組骨摺患者複位後外固定架固定，切開減張治療後創麵敷貼負壓封閉吸引材料-聚乙烯乙醇水化海藻鹽泡沫，皮緣用皮膚吻閤器作釦環採用硅橡膠袢充噹縳帶採用切口綁鞋帶治療技術。治療後1箇月比較兩組患者切口大小、切口完全閉閤切口所需時間、感染情況、需進一步榦預的需求、日常治療費用等情況。結果與結論：綁鞋帶組切口閉閤所需時間顯著優于負壓吸引組(P<0.05)。負壓吸引組中有8箇減張切口需行進一步植皮，綁鞋帶組無需行植皮；綁鞋帶組中5箇減張切口需要更換硅橡膠袢。兩組中創麵感染率比較差異無顯著性意義，也均未齣現治療後觔膜間室壓力增高及皮緣壞死等現象。結果提示，真空負壓吸引技術和綁鞋帶技術均為治療小腿骨觔膜間室綜閤徵切開減張切口安全、有效的治療技術，其療效可靠，已被臨床使用；與真空負壓吸引技術相比，綁鞋帶技術傷口閉閤時間短、創傷小、療效更優。
배경：목전인위부압흡인기술시치료골근막간실종합정절개감압절구교안전、유효적방법，단시치료후창면왕왕불능자행폐합，수요식피조성부손상。유연구표명응용방혜대기술치료소퇴골근막간실종합정감장절구취득량호적효과，단국내지금소유보도。목적：비교진공부압흡인기술여방혜대기술치료소퇴골근막간실종합정절개감장절구적료효。방법：장36례소퇴골근막실종합정환자환자(46개감장절구)수궤분위부압흡인조화방혜대조，매조각23개감장절구，부압흡인조골절복위후외고정가고정，절개감장후즉행부압봉폐인류치료；방혜대조골절환자복위후외고정가고정，절개감장치료후창면부첩부압봉폐흡인재료-취을희을순수화해조염포말，피연용피부문합기작구배채용규상효번충당박대채용절구방혜대치료기술。치료후1개월비교량조환자절구대소、절구완전폐합절구소수시간、감염정황、수진일보간예적수구、일상치료비용등정황。결과여결론：방혜대조절구폐합소수시간현저우우부압흡인조(P<0.05)。부압흡인조중유8개감장절구수행진일보식피，방혜대조무수행식피；방혜대조중5개감장절구수요경환규상효번。량조중창면감염솔비교차이무현저성의의，야균미출현치료후근막간실압력증고급피연배사등현상。결과제시，진공부압흡인기술화방혜대기술균위치료소퇴골근막간실종합정절개감장절구안전、유효적치료기술，기료효가고，이피림상사용；여진공부압흡인기술상비，방혜대기술상구폐합시간단、창상소、료효경우。
BACKGROUND:Vacuum sealing drainage is currently considered as a safe and effective for fasciotomy wounds in the treatment of compartment syndrome. But the wounds after treatment are often not self-closed, which needs skin grafts that can cause secondary injury. Studies have shown that shoelaces technology is useful for leg fasciotomy wounds in the surgical treatment of lower leg compartment syndrome, but so far there are few domestic reports. OBJECTIVE:To compare the vacuum sealing drainage and shoelace technique for treatment of leg fasciotomy wounds. METHODS:A total of 36 patients, with 46 leg fasciotomy wounds, were randomized into vacuum sealing drainage and shoelace technique groups, 23 wounds in each group. In the vacuum sealing drainage group, patients were subjected to vacuum sealing drainage after fasciotomy based on fracture reduction and external fixation;in the shoelace technique group, the fasciotomy wounds were covered with polyethylene/ethanol hydrated seaweed salt foam fol owed by shoelace technique. After 1 month, wound size, wound closure time, infection, further intervention and daily treatment cost were compared between the two groups. RESULTS AND CONCLUSION: Wound closure time was significantly higher in the vacuum sealing drainage group compared to the shoelace technique group (P < 0.05). Eight wounds in the vacuum sealing drainage group required skin grafts; while, no skin graft was necessary in the shoelace technique group. In the shoelace technique group, the vessel loops had to be replaced in five wounds. There was no wound infection, increased compartment pressure and skin flap necrosis postoperatively in both two groups. Both vacuum sealing drainage and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. Vacuum sealing drainage requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.
