CAJ | 학술논문

目的：探讨持续肝素钠盐水冲洗预防负压封闭引流术（vacuum sealing drainage，VSD）后引流管阻塞的效果。方法采用配对的方法将74例大面积皮肤缺损患者采用VSD治疗的患者分为实验组和对照组，实验组41例，VSD术后24 h给予生理盐水250 mL+肝素钠12500 U（50 U/mL），以20～30 gtt/min持续滴入创面，每日2次；对照组33例在发生堵管时才用注射器抽取生理盐水20 mL注入敷料浸泡，再接通负压反复操作直至VSD通畅为止。比较两组患者VSD使用时间、引流管通畅率、创面愈合时间、组织病理学评分情况。结果两组患者VSD使用时间、引流管通畅率、创面愈合时间、组织病理学评分比较，均P＜0.05，差异具有统计学意义，实验组患者VSD使用时间明显长于对照组，创面愈合时间明显短于对照组，引流管通畅率明显高于对照组，组织病理学评分明显高于对照组。结论持续肝素钠盐水冲洗法可有效降低VSD堵管发生率，促进创面愈合。
목적：탐토지속간소납염수충세예방부압봉폐인류술（vacuum sealing drainage，VSD）후인류관조새적효과。방법채용배대적방법장74례대면적피부결손환자채용VSD치료적환자분위실험조화대조조，실험조41례，VSD술후24 h급여생리염수250 mL+간소납12500 U（50 U/mL），이20～30 gtt/min지속적입창면，매일2차；대조조33례재발생도관시재용주사기추취생리염수20 mL주입부료침포，재접통부압반복조작직지VSD통창위지。비교량조환자VSD사용시간、인류관통창솔、창면유합시간、조직병이학평분정황。결과량조환자VSD사용시간、인류관통창솔、창면유합시간、조직병이학평분비교，균P＜0.05，차이구유통계학의의，실험조환자VSD사용시간명현장우대조조，창면유합시간명현단우대조조，인류관통창솔명현고우대조조，조직병이학평분명현고우대조조。결론지속간소납염수충세법가유효강저VSD도관발생솔，촉진창면유합。
Objective To study the effect of continuing flushing with heparin on the prevention of tube obstruction after vacuum sealing drainage(VSD).Methods Seventy-four patients with large area of skin defects treated by VSD were randomly divided into experiment group and control group. The experiment group were managed by continuous infusion with saline at 250 mL and heparin at 12500 U (50 U/mL)in 24 h after operation,with 20 to 30 drops per minute and two times a day. The control group included 33 cases was injected with 20 mL saline when the drainage tube blocked until the VSD tube was unobstructed. The two groups were compared in terms of drainage time, drainage tube,wound healing time,rate of un-obstruction of tubes and histopathological scores.Results The drainage time and wound healing time of experiment group were significantly shorter than that of control group(P<0.05). The rate of un-obstruction of tubes was higher than the control group and so it was with the score in histopathology.Conclusion Continuous flushing with heparin can effectively reduce the incidence of VSD obstruction and promote wound healing.