摘要
目的探讨GustiloⅢ型开放性骨折术后慢性难愈性创面感染治疗中应用负压封闭引流(VSD)技术的临床价值。方法选取2016年6月-2017年8月医院收治的78例GustiloⅢ型开放性骨折手术治疗后出现慢性难愈性创面感染患者作为研究对象,随机分为试验组和对照组,每组39例。对照组患者采用常规药物治疗,试验组患者采用VSD技术治疗,比较两组患者治疗总有效率、并发症发生率、术后康复出院时间及术后白细胞计数、血沉及C-反应蛋白等指标改善情况。结果试验组治疗总有效率高于对照组(χ^2=5.708,P=0.017);后期随访调查发现,试验组发生畸形愈合、患肢功能障碍及骨髓炎等并发症概率低于对照组(χ^2=7.415,P=0.006);试验组患者康复出院时间短于对照组(P<0.05);治疗后试验组患者白细胞计数、血沉及C-反应蛋白指标改善情况优于对照组(P<0.05);GustiloⅢ型开放性骨折术后慢性难愈性创面感染患者共检出84株病原菌,其中革兰阳性菌51株占60.71%。结论 GustiloⅢ型开放性骨折术后慢性难愈性创面感染患者采用负压封闭引流治疗效果较好,提升了创面愈合速率,缩短了患者住院时间,不良反应少,治疗安全性高。
OBJECTIVE To explore the clinical value of vacuum sealing drainage(VSD)in treatment of Gustilo typeⅢopen fracture patients with postoperative chronic refractory wound infection.METHODS From Jun 2016 to Aug,2017,a total of 78 patients with Gustilo typeⅢopen fracture who had chronic refractory wound infection after surgical procedures were recruited as the study objects and randomly divided into the experimental group and the control group,with 39 cases in each group.The control group was treated with conventional drugs,while the experimental group was treated with VSD.The total effective rate of treatment,incidence of complications and time of postoperative rehabilitation and discharge as well as postoperative white blood cell counts,erythrocyte sedimentation rate(ESR)and C-reactive protein were observed and compared between the two groups of patients.RESULTS The total effective rate of treatment of the experimental group was 94.87%(37/39),significantly higher than 84.62%(33/39)of the control group(χ^2=5.708,P=0.017).The follow-up result indicated that the incidence rates of complications such as malunions,dysfunction of affected extremity and osteomyelitis were significantly lower in the experimental group than in the control group(χ^2=7.415,P=0.006).The time of rehabilitation and discharge of the experimental group was significantly shorter than that of the control group(P<0.05).The white blood cell counts,ESR and C-reactive protein were significantly improved better in the experimental group than in the control group after the treatment(P<0.05).Totally 84 strains of pathogens were isolated from the Gustilo typeⅢopen fracture patients with postoperative chronic refractory wound infection.CONCLUSION VSD may achieve remarkable curative effect on the Gustilo typeⅢopen fracture patients with postoperative chronic refractory wound infection,raise the wound healing rate,shorten the length of hospital stay and lead to less adverse reactions,with the safety high.
作者
李凤玲
李欣莹
王富艳
王丽梅
刘倩
LI Feng-ling;LI Xin-ying;WANG Fu-yan;WANG Li-mei;LIU Qian(Affiliated Provincial Hospital of Shandong University,Jinan ,Shandong 250022,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第1期113-116,共4页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(Y2006C69)
