本文選題：負(fù)壓封閉引流 + 慢性難愈性創(chuàng)面　； 參考：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:本研究通過(guò)回顧性分析負(fù)壓封閉引流技術(shù)治療壓力性潰瘍創(chuàng)面、糖尿病潰瘍創(chuàng)面患者的資料,探討負(fù)壓封閉引流治療難愈性創(chuàng)面的效果方法:對(duì)166例慢性難愈性創(chuàng)面患者(其中壓力性潰瘍創(chuàng)面患者118例,糖尿病潰瘍創(chuàng)面48例)的臨床資料進(jìn)行回顧性分析。根據(jù)兩組資料中患者在治療過(guò)程中是否使用負(fù)壓封閉引流技術(shù)再分為VSD治療組和對(duì)照組,對(duì)患者從入院至滿足條件行二期手術(shù)(局部皮瓣轉(zhuǎn)移術(shù)或植皮術(shù))的時(shí)間和手術(shù)封閉創(chuàng)面后患者創(chuàng)面的愈合效果做出統(tǒng)計(jì)學(xué)分析。結(jié)果:1、壓力性潰瘍創(chuàng)面治療過(guò)程中,VSD治療組從入院至滿足條件行二期手術(shù)所需時(shí)間為12.89±7.064天;對(duì)照組從入院至滿足條件行二期手術(shù)所需時(shí)間為為19.83±10.897天。經(jīng)兩獨(dú)立樣本T檢驗(yàn),t=-3.892,P0.01,具有顯著的統(tǒng)計(jì)學(xué)意義。2、壓力性潰瘍創(chuàng)面治療過(guò)程中,行手術(shù)治療封閉創(chuàng)面2周后,VSD治療組中有48例痊愈,16例顯效,6例無(wú)效,治愈率為68.57%;對(duì)照組中有28例痊愈,10例顯效,10例無(wú)效,治愈率為58.33%。經(jīng)Wilcoxon秩和檢驗(yàn),P0.01,具有統(tǒng)計(jì)學(xué)意義。3、糖尿病潰瘍創(chuàng)面治療過(guò)程中,VSD治療組從入院至滿足條件行二期手術(shù)所需時(shí)間為10.90±6.226天;對(duì)照組從入院至滿足條件行二期手術(shù)所需時(shí)間為18.53±5.433天。經(jīng)T檢驗(yàn),t=-4.413,P0.01,具有的統(tǒng)計(jì)學(xué)意義。4、糖尿病潰瘍創(chuàng)面治療過(guò)程中,行二期手術(shù)2周后,VSD治療組中有24例痊愈,4例顯效,3例無(wú)效,治愈率為77.45%;對(duì)照組中有9例痊愈,5例顯效,3例無(wú)效,治愈率為52.94%。經(jīng)Wilcoxon秩和檢驗(yàn),P0.01,具有顯著統(tǒng)計(jì)學(xué)意義。結(jié)論:負(fù)壓封閉引流技術(shù)能加快創(chuàng)面肉芽生長(zhǎng)速度,顯著的縮短患者從入院至行二期手術(shù)封閉創(chuàng)面所需的時(shí)間。且對(duì)比于傳統(tǒng)的清創(chuàng)換藥治療方法比,行負(fù)壓封閉引流術(shù)聯(lián)合皮瓣或植皮術(shù)治療慢性難愈性創(chuàng)面的效果顯著提高。負(fù)壓封閉引流技術(shù)是治療慢性難愈性創(chuàng)面的一種簡(jiǎn)單、有效的方法。
[Abstract]:Objective: to retrospectively analyze the data of patients with pressure ulcer and diabetic ulcer treated by negative pressure sealing drainage. Methods: the clinical data of 166 patients with chronic refractory wounds (including 118 patients with pressure ulcer and 48 patients with diabetic ulcer) were analyzed retrospectively. According to the data of the two groups, the patients were divided into two groups: VSD treatment group and control group. The time of secondary operation (local flap transfer or skin grafting) from admission to condition was analyzed statistically. Results in the treatment of stress ulcer wounds, the time of secondary operation was 12.89 鹵7.064 days in the VSD group and 19.83 鹵10.897 days in the control group. After two independent T tests, there was significant statistical significance. During the treatment of pressure ulcer wounds, 48 cases were cured and 6 cases were ineffective in VSD treatment group after 2 weeks of operation. The cure rate was 68.57 and the cure rate was 58.33 in the control group. After Wilcoxon rank sum test (P 0.01), there was statistical significance. During the treatment of diabetic ulcer wound, the time from admission to condition was 10.90 鹵6.226 days in the treatment group and 18.53 鹵5.433 days from admission to condition in the control group. In the treatment of diabetic ulcer wounds, 24 cases were cured 2 weeks later in VSD treatment group, 4 cases were cured, 3 cases were ineffective, the cure rate was 77.45%, in the control group, 9 cases were cured, 5 cases had obvious effect and 3 cases had no effect. The cure rate was 52.94. Wilcoxon rank sum test showed significant statistical significance (P 0.01). Conclusion: the technique of negative pressure sealing and drainage can accelerate the growth rate of granulation and shorten the time of wound sealing from admission to secondary operation. Compared with the traditional methods of debridement and dressing replacement, the effect of negative pressure sealing drainage combined with skin flap or skin grafting on chronic refractory wounds was significantly improved. Negative pressure sealing and drainage is a simple and effective method for the treatment of chronic refractory wounds.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R641

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