可调节负压吸引技术在体表慢性难愈创面修复中的应用.docVIP

　　可调节负压吸引技术在体表慢性难愈创面修复中的应用 [摘要]目的：初步观察可调节负压吸引技术修复体表难愈创面的临床效果。方法：对68例复杂难愈性体表创面患者给予间歇性负压吸引治疗，即：负压压力大小为70～90mmHg，持续负压吸引5min，间歇1min。每7d为一个治疗周期，给予一个或者数个间歇性负压吸引治疗周期后，根据创面肉芽组织生长或者创面愈合情况，行植皮术或者皮瓣转移术修复创面。结果：68例患者经过一次或数次的负压吸引治疗，66例创面基底达到手术需求，然后创面通过植皮或者皮瓣转移修复；2例创面直接愈合。均无明显并发症发生。结论：可调节负压吸引技术治疗体表复杂难愈性创面简单、经济、安全有效。 .　　[关键词]可调节负压吸引技术；修复；难愈创面；植皮术；皮瓣 　　[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2015）23-0001-04 　　Abstract： Objective To preliminary observe the clinical effects of regulated negative pressure therapy（RNPT）on complex refractory wounds. Methods 68 cases of complex refractory surface wound were treated with intermittent negative pressure.Namely：the negative pressure of the size was 70-90mmHg.Continuous negative pressure suction for 5 minutes，1 minute interval.Every 7 days was a treatment cycle.According to the wound granulation tissue growth and wound healing，one or a plurality of intermittent negative pressure treatment cycle was given.Then the operations of skin grafting or flap transfer were carried out to repair the wounds. Results 68 patients were treated by regulated negative pressure therapy at one or more times.66 cases of wound surface met the needs of surgery.Then the wounds were repaired through the skin grafting or flap transfer.2 cases of wound healed without operation.No obvious complications occurred. Conclusion Regulated negative pressure therapy is simple，economic，safe and effective in the treatment of complex refractory surface wounds. 　　Key words：regulated negative pressure therapy（RNPT）；repairing；complex refractory wounds；grafting； flap 　　许多疾病所导致的各类皮肤溃疡患者日益增多，如静脉性溃疡、压迫性溃疡、失神经性溃疡、糖尿病性溃疡、放射性溃疡等，此类创面经久不愈，如未得到及时正确的治疗，易导致严重后果。而负压封闭引流技术（vacuum sealing drainage，VSD）在此类创面的应用取得了明显效果，使长期困扰患者并给患者带来沉重经济负担的疾患得到了及时救治。但是随着临床的广泛应用发现尚有不足，如常规负压封闭引流技术为固定压力值持续吸引；创面术后即长时间吸引可能导致创面出血；加重深部组织感染和局部组织压迫坏死等[1]。近年来笔者充分利用其“能切善补”的专业技术优势，积极收治难愈性创面患者，应用改良的VSD技术即可调节负压吸引技术（regulated negative pressure therapy，RNPT）治疗难愈性创面，显示出其有效性，现报道如下。 　　1 资料和方法 　　1.1 一般资料 　　2010年03月-2015年03月笔者所在科收治复杂难愈性创面患者6