CAJ | 학술논문

目的分析封闭负压疗法(VAC)治疗褥疮失败与相关因素的关系,指导临床适应证的选择. 方法回顾2010年3月至2013年3月应用VAC治疗褥疮患者75例,分析12个预测变量与VAC失败的相关性,筛选有统计学意义的预测因素,计算其敏感性、特异性、阳性预测值、阴性预测值,再进一步行Logistic回归分析. 结果 75例褥疮病例有17例VAC治疗失败.影响褥疮愈合的12项危险因素中,血细菌培养阳性、骨质暴露、低蛋白血症和创面深度≥4 cm与治疗失败呈相关性(P≤0.05),其失败率分别为70.0％、50.0％、38.5％、40.9％,Logistic回归分析未发现上述4因素是导致VAC治疗失败的独立因素. 结论血细菌培养阳性、骨质暴露、低蛋白血症和创面深度≥4 cm发生VAC治疗失败几率较高,是VAC治疗褥疮的相对适应证.
목적 분석봉폐부압요법(VAC)치료욕창실패여상관인소적관계,지도림상괄응증적선택. 방법 회고2010년3월지2013년3월응용VAC치료욕창환자75례,분석12개예측변량여VAC실패적상관성,사선유통계학의의적예측인소,계산기민감성、특이성、양성예측치、음성예측치,재진일보행Logistic회귀분석. 결과 75례욕창병례유17례VAC치료실패.영향욕창유합적12항위험인소중,혈세균배양양성、골질폭로、저단백혈증화창면심도≥4 cm여치료실패정상관성(P≤0.05),기실패솔분별위70.0％、50.0％、38.5％、40.9％,Logistic회귀분석미발현상술4인소시도치VAC치료실패적독립인소. 결론 혈세균배양양성、골질폭로、저단백혈증화창면심도≥4 cm발생VAC치료실패궤솔교고,시VAC치료욕창적상대괄응증.
Objective To study the factors relating to failure of vacuum assisted closure (VAC)therapy for pressure ulcers control in order to guide the clinical indications.Methods A retrospective cohort study of 75 patients with pressure ulcers to undergo VAC therapy was conducted.Correlations between 12 risk factors and VAC therapy failure were analyzed.The statistical prognostic factors were screened and the sensitivity,specificity,positive predictive value and negative predictive value of them were analyzed.Risk factors for VAC failure were determined by using Logistic regression analysis.Results Among the 75 patients,17 patients failed to respond to the VAC therapy.The failure rate of VAC therapy had correlations with positive blood cultures,bony exposure,hypoalbuminemia (alb ＜25 g/L) and wound depths≥ 4 cm (70.0％,50.0％,38.5％ and 40.9％,respectively),but the Logistic regression analysis found that the 4 factors were not the independent risk factors for failure of VAC therapy.Conclusions Pressure ulcer patients with positive blood cultures,bony exposure,hypoalbuminaemia (alb ＜25 g/L),and wound depth≥4 cm tend to have a higher failure rate in VAC therapy,which are the relative indications for VAC therapy.