江平　梁王班　陳可鋒

【摘要】 目的 探究改良后清創(chuàng)引流用于整形外科慢性潰瘍的效果。方法 116例整形外科慢性潰瘍患者， 隨機(jī)分為對(duì)照組與觀察組， 每組58例。對(duì)照組采用常規(guī)引流方式， 觀察組采用負(fù)壓封閉引流術(shù)。觀察比較兩組患者的治療效果以及相關(guān)治療指標(biāo)。結(jié)果 觀察組患者的治療總有效率為98.28%（57/58）， 對(duì)照組患者的治療總有效率為72.41%（42/58）， 觀察組患者的治療總有效率高于對(duì)照組， 差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組患者的日引流量（59.67±10.34）ml明顯高于對(duì)照組的（13.25±5.83）ml， 住院時(shí)間（20.54±4.25）d、創(chuàng)面愈合時(shí)間（15.11±1.32）d短于對(duì)照組的（30.92±7.48）、（29.26±3.04）d， 換藥次數(shù)（11.21±2.27）次少于對(duì)照組的（25.87±3.59）次， 差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 負(fù)壓封閉引流術(shù)能夠有效提高整形外科慢性潰瘍的治療效果， 縮短創(chuàng)面的愈合時(shí)間和患者的住院時(shí)間， 促進(jìn)患者的恢復(fù)。

【關(guān)鍵詞】 改良后清創(chuàng)引流;負(fù)壓封閉引流術(shù);整形外科;慢性潰瘍

DOI：10.14163/j.cnki.11-5547/r.2020.06.011

Effect of modified debridement and drainage for the treatment of chronic ulcers in plastic surgery? ?JIANG Ping， LIANG Wang-ban， CHEN Ke-feng. Yangjiang Yangdong District Peoples Hospital， Yangjiang 529900， China

【Abstract】 Objective? ?To investigate the effect of modified debridement and drainage for the treatment of chronic ulcers in plastic surgery. Methods? ?A total of 116 patients with chronic ulcers in plastic surgery were randomly divided into control group and observation group， with 58 cases in each group. The control group received conventional drainage， and the observation group received vacuum sealing drainage. The therapeutic effect and related treatment indicators were observed and compared between the two groups. Results? ?The total effective rate of treatment was 98.28%（57/58） in the observation group， which was 72.41%（42/58） in the control group. The total effective rate of treatment in the observation group was higher than that in the control group， and the difference was statistically significant （P<0.05）. The daily drainage volume （59.67±10.34） ml in the observation group was obviously higher than （13.25±5.83） ml in the control group， hospitalization time （20.54±4.25） d

and wound healing time （15.11±1.32） d were shorter than （30.92±7.48） and （29.26±3.04） d in the control group， and frequency of dressing （11.21±2.27） times was less than （25.87±3.59） times in the control group. Their difference was statistically significant （P<0.05）. Conclusion? ?Vacuum sealing drainage can effectively improve the therapeutic effect of chronic ulcers in plastic surgery， shorten wound healing time and hospitalization time， thus promoting recovery of patients.

【Key words】 Modified debridement and drainage; Vacuum sealing drainage; Plastic surgery; Chronic ulcers

慢性潰瘍創(chuàng)面是由于各種因素的作用， 在正常修復(fù)機(jī)制下創(chuàng)面無(wú)法愈合， 導(dǎo)致病理性炎癥反應(yīng)狀態(tài)， 傷口經(jīng)久不愈， 并且往往伴有炎性滲出[1-3]。慢性潰瘍病程長(zhǎng)， 治療難度較大， 嚴(yán)重影響患者的生活質(zhì)量。過(guò)去使用外科清創(chuàng)換藥的方式治療， 耗費(fèi)人力和時(shí)間， 效果不理想。目前治療慢性潰瘍， 逐漸通過(guò)整形手術(shù)和負(fù)壓封閉引流。整形手術(shù)可以將潰瘍創(chuàng)面及瘢痕組織徹底清除， 對(duì)創(chuàng)面進(jìn)行深度處理， 然后通過(guò)皮瓣或者皮片修復(fù)。負(fù)壓封閉引流術(shù)可以改善創(chuàng)面周?chē)M織微循環(huán)， 去除細(xì)菌培養(yǎng)基， 清潔創(chuàng)面， 抗感染[4， 5]。為探究改良后清創(chuàng)引流用于整形外科慢性潰瘍的效果， 特選取本院整形外科116例慢性潰瘍患者進(jìn)行研究， 現(xiàn)報(bào)告如下。