改良与持续负压引流治疗开放性骨折内固定术后感染的疗效观察.docVIP

改良持续负压引流治疗开放性骨折内固定术后感染的疗效观察 赵伟光 刘振武 刘利 江丽强 谢延平 李艳宝 河北省邯郸市中心医院骨一科，河北邯郸 056001 【摘要】目的：观察改良持续负压引流技术（improved vacuum sealing drainage,VSD)在治疗开放性骨折术后局部感染的临床效果。方法：自2009年1月至2012年1月间我院收治的开放性骨折术后伴局部软组织缺损感染患者80例，随机分为传统VSD组与改良VSD组，后者为在传统的基础上附加一根冲洗管，经冲洗管注入甲硝唑（500mg溶于500ml生理盐水）持续24小时。清创后局部应用VSD膜覆盖。治疗2周后观察两组肉芽生长评分、创面愈合率、堵管率及平均住院时间。SPSS16.0软件进行统计学分析，P0.05认为有统计学意义。结果：改良VSD组肉芽生长评分、创面愈合率、堵管率及住院时间分别为2.8±0.9分、38.6±3.8%、0%、50.0±5.5天；传统VSD对应观察指标分别为2.3±0.4分、23.2±2.5%、20%、64.0±6.7天，两组四个观察指标比较均有统计学意义（P0.05）。结论：改良VSD技术能更有效的促进开放性骨折内固定术后软组织感染的创面愈合和肉芽组织生长，并且降低堵管率及住院时间，是治疗术后感染的有效方法。 【关键词】负压闭式引流，改良；骨折，开放性；感染，术后 Clinical therapeutic effect of improved vacuum sealing drainage on postoperative infection pations of open fracture Zhao weiguang,Liu zhenwu,Liuli,et al.Department of Orthopedics of HanDan Central Hospital,HanDan 056001,Hebei,China. [Abstract]Objective：To investigate the effect of improved vacuum scaling drainage (VSD) on postoperative infection pations of open fracture.Methods： patients were divided into control group and treatment group at random.Patients in control group were treated with routine VSD, the other group were treated with improved VSD, in which irrigation with 500 ml of metronidazole every day via an inserted suction pipe.The growth of granulation tissue score, rate of wound healing,rate of suction pipe blockage.Two weeks alter VSD treatment and the time of patient in hospital were recorded.The statistical results were analyzed by SPSS 16.0 Version. A P value less than 0.05 was considered statistically significant. Results：The indexes of improved VSD group were 3.0±0.9、38.6±3.8%、0%、50.0±5.5 days. Accordingly the routine VSD group were 2.3±0.4、23.2±2.5%、20%、64.0±6.7 days.The datas of two groups were statistically significant(P0.05).Conclusions:Improved VSD is an efficient method to repair postoperative infection pations of open fracture. [Key words]：Vacuum sealing drainage improved Open fracture Postoperative infection 持续负压引流技术（vacuum sealing drainage,VSD)自1994年由裘华德等[1