本文關(guān)鍵詞： 負(fù)壓封閉引流 游離植皮 深度燒傷 感染　出處：《中華醫(yī)院感染學(xué)雜志》2017年09期 　論文類型：期刊論文

【摘要】：目的探討負(fù)壓封閉引流聯(lián)合游離植皮對(duì)深度燒傷感染創(chuàng)面的療效,為臨床提高治愈率提供依據(jù)。方法選取醫(yī)院燒傷科就診的深度燒傷感染患者112例,分為對(duì)照組和研究組,每組各56例,對(duì)照組給予常規(guī)的游離植皮,研究組給予負(fù)壓封閉引流聯(lián)合游離植皮,比較兩組患者的創(chuàng)面愈合時(shí)間、上皮組織完全覆蓋創(chuàng)面時(shí)間、住院時(shí)間、疼痛評(píng)分、10d愈合率、病原菌感染情況、并發(fā)癥發(fā)生率以及植皮成活效果。結(jié)果研究組患者的創(chuàng)面愈合時(shí)間低于對(duì)照組,研究組10d創(chuàng)面愈合率高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);研究組患者的上皮組織完全覆蓋創(chuàng)面時(shí)間、住院時(shí)間均顯著短于對(duì)照組,研究組疼痛評(píng)分低于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);治療前,對(duì)照組共培養(yǎng)出病原菌72株,研究組共培養(yǎng)出病原菌75例,均以革蘭陰性菌為主,主要包括鮑氏不動(dòng)桿菌、銅綠假單胞菌、肺炎克雷伯菌、大腸埃希菌;革蘭陽(yáng)性菌主要包括表皮葡萄球菌和金黃色葡萄球菌;治療后,對(duì)照組感染率為16.1%(9/56),研究組感染率為1.8%(1/56),兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療后,對(duì)照組病原菌以鮑氏不動(dòng)桿菌和大腸埃希菌為主,研究組感染的病原菌為鮑氏不動(dòng)桿菌;研究組患者治療期間的并發(fā)癥發(fā)生率低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);研究組患者的植皮成活總有效率和效果優(yōu)的比例顯著高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論將負(fù)壓封閉引流聯(lián)合游離植皮應(yīng)用于深度燒傷感染創(chuàng)面的治療可以有效促進(jìn)創(chuàng)面愈合、提升總體療效,降低患者感染,減少并發(fā)癥和提升植皮成活率。
[Abstract]:Objective to investigate the effect of negative pressure sealing drainage combined with free skin grafting on deep burn infected wounds, and to provide the basis for clinical improvement of cure rate. Methods 112 patients with deep burn infection were selected and divided into control group and study group. 56 cases in each group were given routine free skin graft in control group, and the patients in study group were given negative pressure closed drainage combined with free skin graft. The wound healing time, the time of complete covering of the wound and the time of hospitalization were compared between the two groups. Results the healing time of the patients in the study group was lower than that in the control group, and the wound healing rate in the study group was higher than that in the control group. The difference was statistically significant (P 0.05), the time of covering the wound completely and the hospitalization time of the patients in the study group were significantly shorter than those in the control group, and the pain score in the study group was lower than that in the control group, and the difference was statistically significant (P 0.05); before treatment, the pain score of the study group was lower than the control group. 72 strains of pathogens were cultured in the control group and 75 cases were cultured in the study group. The main pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli. Gram-positive bacteria mainly included Staphylococcus epidermidis and Staphylococcus aureus. After treatment, the infection rate in the control group was 16.110 / 56.The infection rate in the study group was 1.810 / 56. The difference between the two groups was statistically significant (P 0.05). Acinetobacter baumannii and Escherichia coli were the main pathogens in the control group, Acinetobacter baumannii was the main pathogen in the study group, and the incidence of complications in the study group was lower than that in the control group. The difference was statistically significant (P 0.05), the proportion of total effective rate and excellent effect of skin grafting in the study group was significantly higher than that in the control group. Conclusion the application of negative pressure sealing drainage combined with free skin grafting in the treatment of deep burn infection wounds can effectively promote wound healing, improve the overall efficacy, reduce the infection of patients, reduce complications and increase the survival rate of skin grafts.
【作者單位】： 臺(tái)州市第一人民醫(yī)院燒傷外科;臺(tái)州市第一人民醫(yī)院檢驗(yàn)科;
【基金】：浙江省衛(wèi)生廳醫(yī)藥科技計(jì)劃資助項(xiàng)目(20152922)
【分類號(hào)】：R644

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