發(fā)布時(shí)間：2018-11-02 17:37

【摘要】：目的:通過探討影響斷肢再植成活率、優(yōu)良率的因素及創(chuàng)傷負(fù)壓封閉引流技術(shù)(VSD)在四肢完全毀傷離斷傷斷肢再植術(shù)后治療中的應(yīng)用效果的臨床觀察和研究,為臨床治療斷肢再植及提高斷肢再植成活率、優(yōu)良率提供一定的參考依據(jù)。方法:統(tǒng)計(jì)2008年11月—2014年7月在泰安市中心醫(yī)院、泰山醫(yī)學(xué)院附屬醫(yī)院、解放軍八十八醫(yī)院、泰安市中醫(yī)醫(yī)院行四肢完全毀損離斷傷斷肢再植術(shù)的患者。選擇其中患者40例,隨機(jī)分為兩組,一組為治療組,一組為對(duì)照組,每組患者各20例,治療組、對(duì)照組在斷肢再植術(shù)后按照臨床治療標(biāo)準(zhǔn)進(jìn)行常規(guī)性藥物治療,治療組在常規(guī)性藥物治療基礎(chǔ)上加用創(chuàng)傷負(fù)壓封閉引流裝置治療,運(yùn)用相關(guān)軟件,進(jìn)行回顧性分析,并觀察創(chuàng)傷負(fù)壓封閉引流技術(shù)在斷肢再植術(shù)后的治療效果。結(jié)果:對(duì)治療組、對(duì)照組患者經(jīng)過7個(gè)月至1年半年回訪后,其中治療組上肢斷肢再植術(shù)10例,下肢斷肢再植術(shù)10例,上肢斷肢成活9例,下肢斷肢成活8例,未成活行截肢術(shù)上肢1例,下肢2例,斷肢成活率85%,對(duì)照組上肢斷肢再植術(shù)10例,下肢斷肢再植術(shù)10例,上肢斷肢成活7例,下肢斷肢成活7例,未成活行截肢術(shù)上肢3例,下肢3例,斷肢成活率70%。按照療效評(píng)價(jià)分析結(jié)果可知,治療組的總優(yōu)良率為85%,對(duì)照組的總優(yōu)良率為70%。治療組成活率、總優(yōu)良率明顯高于對(duì)照組。結(jié)論:四肢斷肢再植術(shù)中應(yīng)用創(chuàng)傷負(fù)壓封閉引流技術(shù)可提高肢體離斷傷再植的成活率和肢體功能的優(yōu)良率。
[Abstract]:Objective: to investigate the factors influencing the survival rate and the excellent rate of amputated limb replantation, and the clinical observation and study on the effect of (VSD) in the treatment of limb replantation after complete limb injury and severed limb replantation. For clinical treatment of amputated limb replantation and improve the survival rate of amputated limb replantation, the excellent and good rate provides a certain reference. Methods: from November 2008 to July 2014, the patients with limb replantation in Taian Central Hospital, affiliated Hospital of Taishan Medical College, 88 Hospital of PLA and Tai'an Hospital of traditional Chinese Medicine were collected. Forty patients were randomly divided into two groups: the treatment group and the control group, 20 patients in each group. The treatment group and the control group were treated with conventional medicine according to the clinical treatment standard after replantation of severed limbs. The treatment group was treated with wound negative pressure sealing drainage device on the basis of routine drug therapy. The treatment effect of wound negative pressure sealing drainage technique after severed limb replantation was analyzed retrospectively by using related software. Results: in the treatment group, the patients in the control group were visited back for 7 months to 1 year. There were 10 cases of upper limb replantation, 10 cases of lower extremity severed limb replantation, 9 cases of upper limb severed limb survival and 8 cases of lower limb severed limb replantation in the treatment group. Amputation was performed in 1 case, lower extremity in 2 cases, survival rate of amputated limb in 85 cases. In the control group, 10 cases were replantation of upper limb, 10 cases were replantation of lower limb, 7 cases were amputation of upper limb, 7 cases of amputation of lower extremity, and 7 cases of amputation of lower extremity. Amputation was performed in 3 cases and lower extremity in 3 cases, and the survival rate of amputation was 70%. According to the results of curative effect evaluation, the total excellent and good rate of the treatment group was 855.The total excellent and good rate of the control group was 70. The survival rate and total excellent and good rate in the treatment group were significantly higher than those in the control group. Conclusion: the application of wound negative pressure sealing drainage in limb replantation can improve the survival rate of limb replantation and the excellent and good rate of limb function.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R658.1

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1 李克芳,程國(guó)玲,韓東景;斷肢再植術(shù)后病人夜間潛在問題的護(hù)理[J];中原醫(yī)刊;2004年09期

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