负压吸引技术治疗褥疮创面疗效观察.docVIP

负压吸引技术治疗褥疮创面疗效观察 　　[摘要] 目的 了解负压吸引技术治疗褥疮创面的效果。方法 选择2007年7月～2010年1月褥疮患者18例,实施手术清创后进行持续负压吸引7～28d,同时进行控制感染、营养支持等全身治疗,观察创面的愈合情况。结果 经过上述处理,患者局部炎性反应明显减轻,一次性愈合6例,游离皮片植皮3例,局部皮瓣转移修复9例;皮片及皮瓣均完全存活,局部外形及功能良好。结论 负压封闭引流技术可缩短褥疮创面愈合时间、提高手术成功率以及减少治疗费用,值得推广应用。 　　[关键词] 褥疮;负压吸引技术;创面愈合 　　[中图分类号] R632.1[文献标识码] A [文章编号] 1673-9701(2010)12-156-02 　　 　　Observation on the Therapeutic Effects of Negative-pressure Wound Therapy on the Pressure Sore 　　LV YingDU YongguiMAO BoZOU TongrongCHEN GuoshuangZHANG PanWU Chen 　　The First People’s Hospital in Yibin City,Yibin 644000,China 　　 　　[Abstract] Objective To study the effects of negative-pressure wound therapy on the pressure sore. Methods Eighteen patients with pressure sore wounds admitted to our hospital from July 2007 to January 2010 were involved.After being debrided,wounds of patients were done with negative-pressure wound therapy for 7～28ds;meanwhile were done with controling infextation,nutritional support etc.The condition of the wounds was observed. Results After above-mentioned treatment,local inflammatory respone of patients was obviously ameliorated,and 6 cases with healing,3 cases with skingrafting,9 cases with regional flap. Free skin graft and skin flap were all survived,and the wounds healed with satisfactory preservation of function and shape. Conclusion Negative-pressure wound therapy can shorten the length of refractory wounds,elevate achievement ratio of operation,reduce therapy cost,which is worth generalization. 　　[Key words] Pressure sore;Negative-pressure wound therapy;Refractory wounds 　　褥疮是整形外科医生在临床上经常会遇到且难以处理的创面。传统的局部治疗方法有换药和手术,对于深度褥疮往往不能通过换药治愈,且增加患者的痛苦、医护人员的工作量以及医疗费用。2007年7月～2010年1月我科应用创面负压吸引治疗褥疮创面18例,疗效良好,现报道如下。 　　1资料与方法 　　1.1一般资料 　　褥疮患者18例,其中男10例,女8例。年龄28～76岁,平均为56.7岁。病史:1～7年。病变部位:骶尾部9例,坐骨结节部6例,胫前2例,踝部1例。创面溃烂的大小:10cm×8cm～30cm×15cm;深浅程度:I度3例,Ⅱ度5例,Ⅲ度7例,Ⅳ度3例。 　　1.2治疗方法 　　1.2.1全身治疗(1)积极控制基础疾病、营养支持治疗以及减轻组织受压。(2)控制感染:术前3～5d加强局部换药;进行细菌学培养和药物敏感试验,根据结果选用抗生素。 　　1.2.2局部治疗将创面变性坏死组织尽量彻底清除;采用医用聚乙烯醇海绵为创面填充材料,按创面大小修