本文選題：持續(xù)封閉負(fù)壓引流技術(shù)（vacuum + sealing　； 參考：《皖南醫(yī)學(xué)院》2013年碩士論文

【摘要】：目的：通過觀察持續(xù)封閉負(fù)壓引流技術(shù)（vacuum sealing drainage，VSD）在急、慢性創(chuàng)面修復(fù)中的臨床應(yīng)用，評(píng)價(jià)其臨床療效及安全性。方法：總結(jié)皖南醫(yī)學(xué)院附屬弋磯山醫(yī)院燒傷整形科2012年01月至2012年12月經(jīng)持續(xù)封閉負(fù)壓引流技術(shù)治療的各種原因所致急、慢性創(chuàng)面患者，共60例，其中男39例，女21例，年齡5-90歲。急性創(chuàng)面40例，慢性創(chuàng)面20例。所有患者均予常規(guī)治療，，高血壓、糖尿病患者予以控制血壓、血糖治療。觀察并記錄患者應(yīng)用VSD治療前、后創(chuàng)面各方面改變，包括創(chuàng)面壞死組織清除、創(chuàng)面細(xì)菌清除、創(chuàng)面肉芽組織生長、是否出現(xiàn)創(chuàng)面出血、過敏等并發(fā)癥，以及應(yīng)用VSD治療過程中患者疼痛程度，VSD治療后創(chuàng)面愈合情況及患者滿意度�；颊邉�(chuàng)面愈后、功能恢復(fù)及滿意度通過定期復(fù)查和電話回訪以問卷調(diào)查的方式收集資料，進(jìn)行統(tǒng)計(jì)分析。結(jié)果：本組60例急、慢性創(chuàng)面患者經(jīng)持續(xù)封閉負(fù)壓引流技術(shù)治療6-20天后，創(chuàng)面壞死組織完全清除，肉芽組織生長新鮮，達(dá)手術(shù)修復(fù)條件的患者有88%。在使用VSD治療的過程中，60例患者中有43例沒有疼痛或輕微疼痛感，僅5例患者不能忍受疼痛，部分患者出現(xiàn)創(chuàng)周皮膚浸漬現(xiàn)象，4例患者出現(xiàn)過敏現(xiàn)象，4例患者出現(xiàn)創(chuàng)面滲血，1例患者創(chuàng)面加重。應(yīng)用負(fù)壓吸引對(duì)創(chuàng)面細(xì)菌有效清除率達(dá)80%，創(chuàng)面細(xì)菌培養(yǎng)陽性率明顯降低，創(chuàng)面治愈率達(dá)100%。愈后隨訪1-12個(gè)月，所有患者關(guān)節(jié)功能漸恢復(fù)正常，創(chuàng)面均愈合良好，未出現(xiàn)創(chuàng)面感染、復(fù)發(fā)、并發(fā)慢性骨髓炎癥狀。植皮創(chuàng)面疤痕增生不明顯，顏色接近正常皮膚，質(zhì)地及耐磨性良好，未見移植皮膚磨損破潰，皮瓣臃腫度漸消，受瓣區(qū)及供瓣區(qū)創(chuàng)面感覺功能逐漸恢復(fù)；患者及家屬滿意度90%。結(jié)論：持續(xù)封閉負(fù)壓引流技術(shù)具有控制創(chuàng)面感染、抑制細(xì)菌生長，清除壞死組織、刺激創(chuàng)面肉芽組織生長，減輕患者痛苦及縮短治療時(shí)間等優(yōu)點(diǎn)，是治療急、慢性創(chuàng)面的一種簡單、有效的方法。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of vacuum sealing drainage drainage (VSD) in the repair of acute and chronic wounds. Methods: from January 2012 to December 2012, the Department of Burn and plastic surgery, affiliated to Southern Anhui Medical College, summarized 60 patients with chronic wounds, including 39 males and 21 females, from January 2012 to December 2012. Age 5-90 years. Acute wound in 40 cases, chronic wound in 20 cases. All patients were given routine treatment, hypertension, diabetes to control blood pressure, blood sugar treatment. The changes of wound surface before and after VSD treatment were observed and recorded, including wound necrosis tissue clearance, wound bacterial clearance, granulation tissue growth, wound bleeding, hypersensitivity and other complications. And the wound healing and patient satisfaction after VSD treatment. After the wound healing, the patients' functional recovery and satisfaction were collected and analyzed by means of regular reexamination and telephone interview. Results: 60 patients with acute and chronic wounds were treated with continuous negative pressure drainage for 6-20 days. The necrotic tissue was completely cleared, granulation tissue grew fresh, and 88 patients reached the condition of operation and repair. In the course of VSD treatment, 43 out of 60 patients had no pain or mild pain, and only 5 patients could not endure pain. There were 4 cases of hypersensitivity in 4 patients and 1 case of aggravated wound surface. The effective clearance rate of bacteria in wound was 80% by suction of negative pressure, the positive rate of bacterial culture in wound was obviously decreased, and the cure rate of wound was 100%. All the patients were followed up for 1 to 12 months. The joint function of all the patients gradually returned to normal. The wound healed well without infection and recurrence of the wound and complicated with chronic osteomyelitis. The scar hyperplasia was not obvious, the color was close to normal skin, the texture and abrasion resistance was good, there was no skin graft wear and tear, the skin flap bloated gradually, the sensory function of the flap and donor flap gradually recovered, and the satisfaction of the patients and their families was 90%. Conclusion: continuous negative pressure drainage has the advantages of controlling wound infection, inhibiting bacterial growth, removing necrotic tissue, stimulating the growth of granulation tissue, alleviating the pain of patients and shortening the time of treatment. A simple and effective method for chronic wounds.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R641

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本文編號(hào)：1795904