摘要
目的目前关于坐骨压疮的清创方式对复发风险的研究较少。文中旨在观察坐骨结节扩大清创术对坐骨结节压疮患者创面预后的影响。方法回顾性分析2013年7月至2020年3月广东省人民医院烧伤与创面修复外科39例诊断为坐骨结节压疮患者的临床资料。根据不同手术方法分为:坐骨扩创组(n=29,坐骨扩创术)及对照组(未进行坐骨扩创术)。统计分析入院时白蛋白、血红蛋白、BMI,有无负压辅助治疗,修复术的平均时间等,记录患者术后生存状态,运用Cox回归模型分析患者坐骨压疮复发的危险因素。结果39例患者共有41处创面,坐骨扩创组创面31处,对照组创面10处。坐骨扩创组术后复发率较对照组明显降低(P<0.001)。Kaplan-meier分析显示,坐骨扩创组无复发生存期较对照组明显升高(P<0.001)。Cox模型进行多因素分析显示,坐骨扩创术是患者伤口复发的保护因素(HR=0.010,95%Cl:0.001~0.177)。结论坐骨结节扩大清创术可有效降低术后压疮的感染复发风险,延长无复发生存期。
Objective Recently,there are few studies on the recurrence risk of debridement methods in sciatic pressure sores.The aim of this study was to observe the effect of extensive debridement of ischium tuberosity on the prognosis of ischium tuberosity pressure ulcer.Methods It was retrospectively analyzed the clinical data of 39 patients diagnosed with ischium tubercle pressure sore in the Department of Burn and Ware Repair,Guangdong Provincial People's Hospital from July 2013 to March 2020.According to the surgical methods,they were divided into two groups:ischial expansion group(n=29,ischial expansion)and control group(no ischial expansion).Statistical analysis was made of albumin,hemoglobin,BMI at admission,negative pressure adjuvant therapy or not,average time of repair,etc.Postoperative survival status of patients was recorded,and Cox regression model was used to analyze the risk factors of patients with sciatic pressure ulcer recurrence.Results There were 41 wounds in 39 patients,31 wounds in ischial expansion group and 10 wounds in control group.The recurrence rate of ischial expansion group was significantly lower than that of control group(P<0.001).Kaplan-Meier analysis showed that the relapse-free survival was significantly higher in the ischial expansion group than in the control group(P<0.001).Multivariate analysis of Cox model showed that ischial expansion was a protective factor for wound recurrence(HR=0.010,95%CL:0.001-0.177).Conclusion Extensive debridement of ischium nodules can effectively reduce the risk of infection and recurrence of postoperative pressure ulcers and prolong the relapse-free survival time.
作者
李汉华
黄志锋
熊兵
郑少逸
刘族安
卞徽宁
孙传伟
马亮华
罗红敏
赖文
LI Han-hua;HUANG Zhi-feng;XIONG Bing;ZHENG Shao-yi;LIU Zu-an;BIAN Hui-ning;SUN Chuan-wei;MA Liang-hua;LUO Hong-min;LAI Wen(Department of Burns and Wound Repair Surgery,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 500180,Guangdong,China)
出处
《医学研究生学报》
CAS
北大核心
2021年第4期379-383,共5页
Journal of Medical Postgraduates
基金
广东省自然科学基金(2018A0303130040)。
关键词
坐骨结节
坐骨扩创术
压疮
创面
复发
ischial tuberosity
ischium debridement
pressure sore
bursa
direct closure
