负压封闭引流术联合创面冲洗在难愈性胸壁结核创面中的应用

doi:10.3969/j.issn.1005-6483.2020.12.015

摘要/Abstract

摘要： 目的总结负压封闭引流术联合创面引流冲洗在难愈性胸壁结核创面的应用价值。
方法 2015年1月～2020年1月我胸外科收治的难愈性胸壁结核创面病人75例，回顾性分析病人所接受的处理措施及治疗效果，术后处理方式根据皮肤缺损情况分为Ⅰ期缝合引流管引流(A组)，负压封闭引流及创面冲洗(B组)，减张缝合常规换药(C组)；非手术病人在抗结核及抗感染治疗的同时分为负压封闭引流及创面冲洗(D组)，常规冲洗换药(E组)。
结果抗感染药物使用时间A组为(18.611±1.787)天， B组为(20.158±1.893)天, C组为(27.571±3.006)天,组间比较差异有统计学意义（P<0.05）；非手术病人D组为(21.455±3.045)天，E组为（27.923±2.178)天,两组间比较差异有统计学意义（P<0.05）；创面愈合时间A组为(17.167±6.662)天， B组为(26.579±3.991)天,C组为(36.786±5.102)天，组间比较差异有统计学意义（P<0.05）；非手术病人D组为(29.273±7.072)天，E组为(48.923±8.893)天,两组间比较差异有统计学意义（P<0.05）。治疗前3天VAS疼痛评分A组为(2.361±0.637)分，B组为(2.648±0.853)分,差异无统计学意义（P>0.05）；B组为(2.648±0.853)分， C组为(5.429±1.124)分,组间比较差异有统计学意义（P<0.05）；D组为(3.455±1.293)分，E组为(5.192±0.855)分,组间比较差异有统计学意义（P<0.05）。
结论在难愈性胸壁结核创面的治疗中应用负压创面引流联合创面冲洗，可加快治愈进程，减少抗菌药物使用时间，减轻病人痛苦。

关键词: 难愈性创面, 胸壁结核, 负压封闭引流, 创面冲洗, 康复

Abstract: Objective To summarize and analyze the application value of vacuum sealing drainage combined with wound drainage and washing in refractory chest wall tuberculosis.
Methods From January 2015 to January 2020,75 patients with refractory chest wall tuberculosis were selected and analyzed retrospectively.According to the condition of skin defect,the surgical patients were divided into three groups:group A with stage Ⅰ suture drainage,group B with vacuum sealing drainage and wound washing,and group C with conventional tension reduction suture.The non-surgical patients were divided into vacuum sealing drainage(Group D) and wound washing(Group E) at the same time of anti tuberculosis and anti infection treatment.
Result Use time of anti infective Drugs:Group A was (18.611±1.787)days,Group B was (20.158±1.893)days,Group C was (27.571±3.006)days,the difference between the two groups was statistically significant(P<0.05);Group D was (21.455±3.045)days,Group E was (27.923±2.178)days,the difference between the two groups was statistically significant(P<0.05).Wound healing time:Group A was (17.167±6.662)days,Group B was (26.579±3.991)days,Group C was (36.786±5.102)days,the difference between the two groups was statistically significant(P<0.05).Group D was (29.273±7.072)days,Group E was (48.923±8.893)days,The difference between the two groups was statistically significant(P<0.05).VAS pain score 3 days before treatment:the score of group A was (2.361±0.637)，the score of group B was (2.648±0.853)，there was no significant difference(P>0.05)；the score of group B was (2.648±0.853)，the score of group C was (5.429±1.124)，the difference between the two groups was statistically significant(P<0.05).The score of group D was (3.455±1.293),the score of group E was (5.192±0.855),the difference between the two groups was statistically significant(P<0.05).
Conclusion In the treatment of refractory chest wall tuberculosis wounds,the application of negative pressure wound drainage combined with wound washing can speed up the healing process, reduce the use time of antibiotics and relieve the pain of patients.

Key words: refractory wound, tuberculosis of chest wall, vacuum sealing drainage, wound washing, rehabilitation

李潜汪林宝罗佩嘉韦林刘玉钢任磊鹏丁超. 负压封闭引流术联合创面冲洗在难愈性胸壁结核创面中的应用[J]. 临床外科杂志, 2020, 28(12): 1141-1143.

LI Qian, WANG Linbao, lUO Peijia, et, al.. The value of vacuum sealing drainage combined with wound washing in the treatment of refractory chest wall tuberculosis[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(12): 1141-1143.

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