本文選題：難愈性創(chuàng)面 + 負(fù)壓吸引　； 參考：《延安大學(xué)》2017年碩士論文

【摘要】：目的:本研究主要對封閉負(fù)壓吸引技術(shù)聯(lián)合手術(shù)治療在難愈性創(chuàng)面治療上應(yīng)用價值的研究,比較封閉式負(fù)壓吸引技術(shù)聯(lián)手術(shù)治療和常規(guī)換藥聯(lián)合手術(shù)治療兩種治療方法在難愈性創(chuàng)面治療過程中的差異。從而為我國難愈性創(chuàng)面的臨床治療提供新的思路和臨床依據(jù),有助于促進我國難愈性創(chuàng)面治療技術(shù)的發(fā)展,使該技術(shù)在廣大的基層醫(yī)院能夠普及。方法:收集延安大學(xué)附屬醫(yī)院2014年10月至2016年12月所診治的難愈性創(chuàng)面患者共40例,隨機分為封閉負(fù)壓吸引治療組和常規(guī)治療組,每組20例,記錄患者性別、年齡、創(chuàng)面面積等一般情況,簽訂治療知情同意書。負(fù)壓吸引治療組給予負(fù)壓吸引治療技術(shù)聯(lián)合手術(shù)治療,常規(guī)治療組給予常規(guī)換藥聯(lián)合手術(shù)治療。觀察兩組患者治療后創(chuàng)面愈合時間、創(chuàng)面愈合率、創(chuàng)面感染清除時間、換藥次數(shù)、住院時間、首次清創(chuàng)距行手術(shù)治療時間、清創(chuàng)后3、7、11天VAS疼痛評分,得出相關(guān)數(shù)據(jù),應(yīng)用SPSS22.0統(tǒng)計軟件對數(shù)據(jù)進行統(tǒng)計學(xué)處理。結(jié)果:1.封閉負(fù)壓吸引治療組與常規(guī)治療組的一般情況比較封閉負(fù)壓吸引治療組男13例,女7例;常規(guī)治療組男11例,女9例,二者在性別構(gòu)成上無統(tǒng)計學(xué)意義(P0.05);封閉負(fù)壓吸引治療組的年齡為(52.04±7.22)歲,常規(guī)治療組患者的年齡為(49.08±6.94)歲,二者在年齡上無統(tǒng)計學(xué)意義(P0.05);封閉負(fù)壓吸引治療組的創(chuàng)面面積為(45.52±12.34)cm2常規(guī)治療組的創(chuàng)面面積為(40.93±11.64)cm2二者在創(chuàng)面面積上差異無統(tǒng)計學(xué)意義(P0.05),兩組患者的一般情況符合統(tǒng)計學(xué)要求。2.封閉負(fù)壓吸引治療組與常規(guī)治療組的治療后創(chuàng)面愈合時間、創(chuàng)面感染清除時間的比較封閉負(fù)壓吸引治療組的創(chuàng)面愈合時間為(9.65±3.12)天,常規(guī)治療組的創(chuàng)面愈合時間為(17.95±3.35)天,二者之間差異有統(tǒng)計學(xué)意義(p0.05);封閉負(fù)壓吸引治療組的創(chuàng)面感染清除時間為(8.75±2.61)天,常規(guī)治療組的創(chuàng)面感染清除時間為(14.00±3.28)天,二者之間差異有統(tǒng)計學(xué)意義(p0.05)。3.封閉負(fù)壓吸引治療組與常規(guī)治療組的住院時間、首次清創(chuàng)距手術(shù)治療時時間、創(chuàng)面換藥次數(shù)的比較封閉負(fù)壓吸引治療組的住院時間為(18.55±4.29)天,常規(guī)治療組的住院時間為(31.30±6.91)天,二者之間差異有統(tǒng)計學(xué)意義(p0.05);封閉負(fù)壓吸引治療組的首次清創(chuàng)踞手術(shù)治療時間為(7.10±2.17)天,常規(guī)治療組的首次清創(chuàng)距手術(shù)治療時間為(14.20±3.47)天,二者之間差異有統(tǒng)計學(xué)意義(p0.05);封閉負(fù)壓吸引治療組的換藥(敷料)次數(shù)為(1.90±1.37)次,常規(guī)治療組的換藥(敷料)次數(shù)為(14.45±3.80)次,二者之間差異有統(tǒng)計學(xué)意義(p0.05)。4.封閉負(fù)壓吸引治療組與常規(guī)治療組的創(chuàng)面愈合率的比較封閉負(fù)壓吸引治療組創(chuàng)面愈合率為95.00%和常規(guī)治療組的創(chuàng)面愈合率為60.00%,差異有統(tǒng)計學(xué)意義(χ~2=3.91p=0.013)。5.封閉負(fù)壓吸引治療組與常規(guī)治療組的清創(chuàng)后3、7、11天vas疼痛評分的比較.封閉負(fù)壓吸引治療組的首次清創(chuàng)后3天的vas疼痛評分為(4.08±1.25),常規(guī)治療組的首次清創(chuàng)后3天的vas疼痛評分為(6.59±1.30),二者差異有統(tǒng)計學(xué)意義(p0.05);封閉負(fù)壓吸引治療組的首次清創(chuàng)后7天的vas疼痛評分為(3.13±0.72),常規(guī)治療組的首次清創(chuàng)后7天的vas疼痛評分為(4.94±0.97),二者差異有統(tǒng)計學(xué)意義(p0.05);封閉負(fù)壓吸引治療組的首次清創(chuàng)后11天的vas疼痛評分為(1.59±0.74),常規(guī)治療組的首次清創(chuàng)后11天的vas疼痛評分為(3.78±0.53),二者差異有統(tǒng)計學(xué)意義(p0.05)。結(jié)論:1.封閉負(fù)壓吸引治療技術(shù)能有效縮短難愈性創(chuàng)面患者的創(chuàng)面愈合時間及創(chuàng)面感染清除時間。2.封閉負(fù)壓吸引治療技術(shù)能明顯縮短患者的住院時間,使患者能夠盡早接受手術(shù)治療,減少創(chuàng)面換藥次數(shù)。3.封閉負(fù)壓吸引治療技術(shù)能有效提高難愈性創(chuàng)面患者的創(chuàng)面愈合率。4.封閉負(fù)壓吸引治療技術(shù)可以有效緩解難愈性創(chuàng)面患者術(shù)后創(chuàng)面的疼痛程度,減輕患者的痛苦。
[Abstract]:Objective: To study the application value of closed negative pressure suction technique combined with surgical treatment on refractory wounds, and compare the difference between two treatments in the treatment of refractory wounds with closed negative pressure suction technique combined with conventional medicine treatment and the treatment of refractory wounds. The treatment provides new ideas and clinical basis, which helps to promote the development of refractory wound treatment technology in our country and make the technology popularized in the vast grass-roots hospitals. Methods: 40 cases of refractory wounds treated in Affiliated Hospital of Yan'an University from October 2014 to December 2016 were collected, and they were randomly divided into closed negative pressure suction treatment group and usual. The treatment group, 20 cases in each group, recorded the general situation of the patient's sex, age, wound area and other general conditions, and signed the informed consent. The negative pressure attraction treatment group was treated with the combined operation of negative pressure suction therapy, the conventional treatment group was given conventional medicine and combined operation. The healing time of wound wound, wound healing rate and wound surface after treatment were observed in the two groups. The time of infection clearance, the times of change, the time of hospitalization, the time of the first debridement and the time of operation, the VAS pain score of 3,7,11 days after debridement, the relevant data were obtained, and the data were statistically processed with the SPSS22.0 software. Results: 1. the general situation of the closed negative pressure suction treatment group and the conventional treatment group was compared with the closed negative pressure suction treatment group 13 men. There were 7 cases, 11 women and 9 women in the conventional treatment group (P0.05). The age of the closed negative pressure treatment group was (52.04 + 7.22) years, the age of the conventional treatment group was (49.08 + 6.94) years old and the two in the age was not statistically significant (P0.05), and the wound area of the closed negative pressure group was 45.52 + 12. .34) the surface area of cm2 in the conventional treatment group was (40.93 + 11.64) cm2 two, and there was no significant difference in the area of wound surface (P0.05). The general conditions of the two groups were in conformity with the statistical requirements for the wound healing time after the treatment of the.2. closed negative pressure suction group and the conventional treatment group, and the comparison of the clearance time of the wound infection by closed negative pressure suction therapy The wound healing time of the group was (9.65 + 3.12) days, the wound healing time of the conventional treatment group was (17.95 + 3.35) days, the difference between the two groups was statistically significant (P0.05), the clearance time of the wound infection in the closed negative pressure suction group was (8.75 + 2.61) days, and the clearance time of the wound infection was (14 + 3.28) days in the conventional treatment group, and the difference between the two were of the two. Statistical significance (P0.05).3. closed negative pressure suction treatment group and the routine treatment group of hospital time, the first time of debridement in the treatment time, the number of wound dressing, the comparison closed negative pressure group of hospitalization time was (18.55 + 4.29) days, the routine treatment group was (31.30 + 6.91) days, the difference between the two was statistically significant ( P0.05); the treatment time of the first debridement and entrenching operation in the closed negative pressure treatment group was (7.10 + 2.17) days, the time for the first debridement of the conventional treatment group was (14.20 + 3.47) days, the difference between the two groups was statistically significant (P0.05); the change of dressing (dressing) in the closed negative pressure suction group was (1.90 + 1.37) times, and the change of the conventional treatment group (the treatment group) was changed. The number of dressings was (14.45 + 3.80) times. The difference between the two groups was statistically significant (P0.05) the wound healing rate of the closed negative pressure suction treatment group and the conventional treatment group was compared with the conventional treatment group. The wound healing rate in the closed negative pressure suction group was 95% and the wound healing rate in the conventional treatment group was 60%, the difference was statistically significant (x ~2=3.91p=0.013).5. closure. The VAS pain score of 3,7,11 days after debridement in the negative pressure treatment group and the conventional treatment group. The VAS pain score was (4.08 + 1.25) after the first debridement after the first debridement in the closed negative pressure treatment group, and the VAS pain score was (6.59 + 1.30) at 3 days after the first debridement in the routine treatment group (6.59 + 1.30), and the two difference was statistically significant (P0.05); the closed negative pressure was attracted by the treatment group (P0.05). The VAS pain score of 7 days after the first debridement in the treatment group was (3.13 + 0.72). The VAS pain score was (4.94 + 0.97) on the 7 day after the first debridement in the routine treatment group (4.94 + 0.97), and the two difference was statistically significant (P0.05); the vas pain score of the first debridement after the first debridement in the closed negative pressure group was (1.59 + 0.74), and the normal treatment group was vas after the first debridement after the first debridement. The score of the pain was (3.78 + 0.53) and the difference between the two was statistically significant (P0.05). Conclusion: 1. closed negative pressure suction therapy can effectively shorten the healing time of wound healing and the clearance time of wound infection, and.2. closed negative pressure suction therapy can significantly shorten the patient's hospitalization time and enable the patient to receive surgical treatment as soon as possible. .3. closed negative pressure suction therapy can effectively improve the wound healing rate of patients with refractory wounds,.4. closed negative pressure suction therapy can effectively alleviate the degree of pain in the wounds of the patients with refractory wounds and relieve the pain of the patients.
【學(xué)位授予單位】：延安大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R641

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