封闭式负压引流联合植皮术治疗下肢慢性静脉性溃疡的临床疗效.docVIP

精品论文 参考文献 封闭式负压引流联合植皮术治疗下肢慢性静脉性溃疡的临床疗效 詹铁坤 胡秋香 郑梓煜 王维平 广州市中山大学附属第一医院急诊外科 510080 摘 要：【目的】探讨封闭式负压引流联合植皮术治疗下肢慢性静脉性溃疡的临床疗效。【方法】回顾分析我院自2003 年~2010 年收治的78 例下肢慢性静脉性 溃疡的患者。所有患者的溃疡创面均行封闭式负压引流联合植皮术。术后观察溃疡创面愈合情况，评估其临床疗效。【结果】所有患者的溃疡创面均完全愈合。所 有溃疡创面植皮术前平均换药次数为4.2 次(3~8 次)，植皮术后平均换药3.1 次（2~6 次）。随访期内有5 例患者出现溃疡复发，其余患者取皮区伤口愈合良好，受 皮区创面愈合好，皮肤外观、弹性及功能佳。【结论】封闭式负压引流联合植皮术治疗下肢慢性静脉性溃疡临床疗效确切，值得在临床推广。 关键词：封闭式负压引流术；植皮术；慢性静脉性溃疡；临床疗效 Vacuum assisted closure combined with skin grafting in the treatment of chronic venous ulcer of the lower extremities ZHENG Ziyu, YE Jialin, Pan Fushun, WANG Weiping Department of Emergency, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Guangdong, 510080, P.R. China Abstract: 【Objective】To assess the efficacy of vacuum assisted closure combined with skin grafting for the treatment of chronic venous ulcer of the lower extremities.【Methods】We conducted a review of 78 patients who had vacuum assisted closure combined with skin grafting for the treatment of chronic venous ulcer of the lower extremities between 2003 and 2010 in our hospital, and the healing conditions were evaluated postoperatively. 【Results】All wounds were completely healed. The mean number of polyurethane foam dressing changes prior to grafting was 4.2 (three to eight changes). The mean number of VAC foam changes was 3.1 after skin grafting (two to six changes). Five patients had recurrence of venous ulcers in the follow-up period while others achieved good results.【Conclusions】Vacuum assisted closure combined with skin grafting is an effective treatment for chronic venous ulcer of the lower extremities, and itrsquo;s worthwhile to be extended in the clinical work. Key words: Vacuum assisted closure; Skin grafting; Chronic venous ulcer; Efficacy 慢性静脉性溃疡是下肢慢性静脉功能不全（chronic venous insufficiency,CVI）最严重和最难治的并发症，其在人群中的总发病 率为2%~7%，而下肢的慢性溃疡大约有70%是由CVI 所引起[1]。据 报道约有12%~ 14%的CVI 患者存在静脉性溃疡, 该病与远端静脉高 压有关[2]。各种原因所引起的下肢静脉瓣膜功能不全所导致的静脉 异常返流或阻塞或二者合并存在时，