目的：评价负压伤口治疗联合局部给氧对骨科慢性伤口的可行性及效果。方法对60例骨科创伤性慢性伤口患者随机分为两组，每组30例，对照组给予负压伤口治疗，连续10 d。观察组在负压伤口治疗基础上联合局部给氧2 L／min，干预时间同对照组，观察指标：2组治疗0 d和10 d监测伤口渗液pH、温度、PUSH愈合计分、肉芽组织覆盖率、伤口达到植皮条件所需时间、植皮成活率、愈合时间、治愈率。结果治疗10 d后，观察组伤口渗液 pH（7．22±0．16），低于对照组（7．50±0．26）（P＜0．01）。达到植皮条件所需时间（12．65±7．16）d，低于对照组（18．28±8．85）d，伤口床的温度（34．02±0．41）℃，高于对照组（33．25±0．35）℃（P＜0．01）。观察组肉芽组织覆盖率（34．30±2．83）％高于对照组（27．27±3．54）％（P＝0．00）。植皮成活率（93．22±1．91）％，高于对照组（83．21±1．86）％（P＝0．00）。压疮愈合计分量表（pressure ulcer scale for healing，PUSH）计分结果差异无统计学意义（P＞0．05）。所有患者随访3个月，观察组治愈率为86．67％（26／30），平均愈合时间为（35±15．5）d，对照组治愈率为53．33％（16／30），平均愈合时间为（49±23．4）d，差异有统计学意义（P＜0．05）。结论将负压伤口治疗与局部给氧联合应用于骨科慢性伤口能促进伤口愈合及肉芽组织生长，方法可行，效果优于单纯负压治疗。%Objective To evaluate the feasibility to treat chronic wound in orthopedics with method of vacuum assis-ted closure (VAC)combined with irrigation of oxygen.Methods 60 patients with traumatic chronic wound in orthope-dics were divided into 2 groups (30 cases in each groups).VAC was performed in control group for 10 days,while VAC combined with irrigation of oxygen (2 liters/min)was performed in observation group for 10 days as well.pH value of wound exucation,temperature of wound,PUSH (pressure ulcer scale for healing)scores,granulation tissue coverage rate,skin graft survival,the time to reach the required skin grafting conditions and healing time and cure rate of each group were recorded at 0 d and 10 d.Results After ten days of treatment,in the observation group,pH value of wound bed exudate(7.50±0.26)was lower than that of the control group,(7.22±0.16)(P<0.01),The time to reach the re-quired skin grafting conditions(12.65±7.16)was lower than that of the control group(18.28±8.85)(P<0.01).The temperature of wound bed(34.02±0.41)was higher than that of the control group (33.25 ±0.35)(P<0.01).The gran-ulation tissue coverage rate (34.30±2.83)%was higher than that of the control group(27.27 ±3.54)%(P=0.00).The Skin graft survival (93.22±1.91)% was higher than that of the control group (83.21±1.86)% (P=0.00).There was no statistically significant difference between the PUSH score results of the two groups(P>0.05).All patients were followed up for 3 months.The cure rate was 86.67% (26/30)in observation group and 53.33%(16/30)in control group.The healing time was (35±15.5)day in observation group and(49±23.4)d in controlling group.There were sta-tistically significant difference between the two groups (P<0.05 respectively).Conclusion VAC combined with irriga-tion of oxygen can promote granulation tissue growth and wound healing.The method is feasible and is better than VAC therapy.
展开▼
