摘要
目的 观察持续双负压引流对压疮患者皮瓣修复术后炎性因子及创面愈合的影响.方法 自 2020 年 9 月至2022 年 9 月,东莞市人民医院烧伤整形外科以 76 例Ⅲ、Ⅳ期压疮且需行压疮皮瓣修复术的患者作为研究对象,采用数字表随机法分为两组,38 例/组.对照组皮瓣修复术后采用封闭负压引流(vacuum sealing drainage,VSD);观察组皮瓣修复术后采用持续双负压微压力引流,比较两组创面愈合时间、术后住院时间、抗生素使用时间、引流量及并发症发生率.治疗前后检测两组血清炎性指标变化.结果 观察组引流量多于对照组,术后住院时间、抗生素使用时间、创面愈合时间短于对照组,压疮愈合评分(pressure ulcer scale forhealing,PUSH)低于对照组(P＜0.05).治疗后两组TNF-α、IL-6、IL-8 水平均低于治疗前(P＜0.05).观察组治疗后TNF-α、IL-6、IL-8 水平均低于对照组(P＜0.05).观察组患者疗效优、良、可、差的构成比例分别为 50.00%、31.58%、10.53%、7.89%,并发症发生率为 10.53%;对照组分别为 28.95%、36.84%、15.79%、18.42%,并发症发生率为 28.95%;两组差异有统计学意义(P＜0.05).结论 压疮患者皮瓣修复术后采用持续双负压微压力引流能降低炎性细胞因子释放,缩短创面愈合时间和住院时间,提高疗效并降低并发症发生率.
Abstract
Objective To observe the effect of continuous double negative pressure drainage on inflammatory factors and wound healing after skin flap repair in patients with pressure sore.Methods From September 2020 to September 2022,Department of Burn Plastic Surgery,Dongguan People's Hospital,76 patients with stage Ⅲ,Ⅳ pressure sores requiring pressure ulcer flap repair were selected as research objects,and divided into two groups by digital table randomized method,38 patients each group.In the control group received closed negative pressure drainage(VSD)after skin flap repair and in the observation group were treated with continuous double negative pressure micro-pressure drainage after flap repair.The wound healing time,postoperative hospital stay,antibiotic use time,drainage vol-ume and complication rate of the two groups were compared.Serum inflammatory indexes of the two groups were detected before and after treatment.Results The drainage volume of the observation group was higher than that of the control group,the postoperative hospital stay,antibiotic use time and wound healing time were shorter than that of the control group,and the pressure ulcer scale for healing(PUSH)score was lower than that of the control group(P<0.05).After treatment,the levels of TNF-α,IL-6 and IL-8 in 2 groups were lower than before treatment(P<0.05).After treatment,the levels of TNF-α,IL-6 and IL-8 in observation group were lower than those in control group(P<0.05).In the observation group,the proportion of good efficacy but poor efficacy was 50.00％,31.58％,10.53％,7.89％,and the incidence of complications was 10.53％.In the control group,28.95％,36.84％,15.79％,18.42％,the complication rate was 28.95％.The difference was statistically significant(P<0.05).Conclusion Continuous double negative pressure micro-pressure drainage after skin flap repair can re-duce the release of inflammatory cytokines,shorten the wound healing time and hospital stay,improve the curative effect and reduce the in-cidence of complications in patients with pressure sore.
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