摘要
目的探讨难愈性创面修复手术疗效及其影响因素。方法对2009年1月-2014年12月间解放军第85医院烧伤整形外科收治163例难愈性创面患者创面修复手术的临床资料进行回顾性分析。手术疗效分为优、良、差三等。对可能影响手术疗效的指标进行单因素和多因素Logistic回归分析。结果共修复330处创面。创面愈合优、良、差者分别为187、84、59处，优良率为82．12％。单因素分析结果显示：性别、创面细菌、手术时间、围手术期输血、术前血红蛋白、术前白细胞、术前空腹血糖、术前白蛋白与手术疗效有关（P〈0．05），年龄、创面形成原因、手术方式、延期修复、基础疾病、术前肝酶、术前血尿素氮、术前血钾、术前胸部影像学检查、术前心电图检查与手术疗效无明显关系（P〉0．05）。多因素分析显示：性别、手术时间、围手术期输血、术前空腹血糖和术前白蛋白是影响手术疗效的显著影响因素（P〈0．05）。结论手术修复难愈性创面能取得优良的疗效。尽早手术、减少输血、控制血糖和增加营养可提高手术疗效。
Objective To explore the therapeutic outcomes and its prognostic factors in patients with refractory wound repair operation. Methods 163 cases refractory wound patients accepted repair operation from January 2009 to December 2014 were collected. Clinical therapeutic outcomes were assessed according to different level of excellent, good, poor wound healing. Univariate analysis and logistic regression were performed to analyze the prognostic factors of refractory wound repair operation. Results A total of 330 wounds in various parts of the body got different outcomes including excellent in 187 wounds, good in 84wounds and poor in 59 wounds. Total rate of excellent and good was 82.12%. Univariate analysis showed that gender, wound bacterial, operation time, perioperative blood transfusion, preoperative hemoglobin, preoperative white blood ceils, preoperative fasting glucose and preoperative albumin were associate with operation outcomes （P 〈0.05）, but age, wound causes, operation methods, delayed repaired, concurrent chronic diseases, preoperative liver enzymes, preoperative blood urea nitrogen, preoperative serum potassium, preoperative electrocardiogram and chest radiographic had no significant relation with therapeutic effects （P 〉0.05）. After multiple factors logistic regression analysis, gender, operation time, perioperative blood transfusion, preoperative fasting glucose and preoperative albumin were the influential factors of operation outcomes （P 〈0.05）. Conclusion It might get excellent and good results for refractory wound repair operation. Early operation, reduced perioperative blood transfusion, feasible blood sugar and improved nutrition status can promote operation outcomes.
作者
许献荣
倪俊
陈瑞彩
顾海峰
王滢
XU Xian-rong NI Jun CHEN Rui-cai GU Hai-feng Wang Ying.(Department of Burns and Plastic Surgery, 85th Hospital of PLA, Shanghai 200052, Chin)
出处
《中国急救复苏与灾害医学杂志》
2017年第3期236-239,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
难愈性创面
手术
创面愈合
治疗结果
危险因素
refractory wound
operation
wound healing
treatment outcome
risk factors
