應用研究
簡易負壓封閉引流技術在25例腹部創傷患者感染切口中的應用效果
李永剛 李 平 趙光鋒 廖 文 譚 浪 吳 燕*
【摘要】 目的 觀察簡易負壓封閉引流技術在腹部創傷患者感染切口中的應用效果。方法 對照組（n=25）給予現有負壓封閉引流VSD材料治療感染切口，觀察組（n=25）給予簡易負壓封閉引流技術治療感染切口，對比兩組的沖洗引流效果、肉芽組織生長影響、耗材費用及切口愈合時間。
【關鍵字】 腹部創傷,簡易負壓封閉引流技術,感染切口,愈合,耗材費用
中圖分類號：文獻標識碼：文章編號：
[Abstract] Objective This study aims to observe the application effect of simple negative pressure sealing drainage technique in the infected incision of patients with abdominal trauma. Methods The control group (n=25) was treated with the existing negative pressure sealing drainage VSD material to treat the infected incision, and the observation group (n=25) was treated with the simple negative pressure sealing drainage technology to treat the infected incision. It compared the effect of washing and drainage, the effect of granulation tissue growth, the cost of consumables and the time of wound healing. Results There were 24 patients (96.00%) with smooth irrigation and drainage in both groups, 1 case (4.00%) with pipeline blockage and poor drainage in VSD, and there was no significant difference in the effect of irrigation and drainage between the two groups (χ2=0.000, P=1.000). In the observation group, 22 cases (88.00%) had clean wounds, rosy granulations, and self-healing incisions after VSD, 3 cases (12.00%) needed to use VSD twice or more, and intermittent sutures after debridement. In the control group, 22 cases (88.00%) had clean wounds, rosy granulations, and self-healing incisions after VSD, 3 cases (12.00%) who needed VSD for 2 or more times, and intermittent sutures after debridement of incisions, and there was no significant difference in the growth effects of granulation tissue between the two groups (χ2=0.000, P=1.000). In the observation group, the consumables cost of 50 yuan for 14 cases (56.00%), 100 yuan for 5 cases (20.00%), 150 yuan for 3 cases (12.00%), and 3 cases (12.00%) for intermittent suture after local anesthesia debridement after incision, a total of 2 550 yuan was used. Each patient in the control group was free of charge with one existing disposable negative pressure drainage protection material (moisturizer), worth 3 280 yuan per piece, of which 19 patients used one post-granulation ruddy and incision healing without follow-up costs; 3 patients used one more, with a total cost of 9840 yuan; Two patients added intermittent sutures after local anesthesia debridement after using two VSD consumables, the cost was 13 120 yuan, and 1 patient added three VSD consumables after incision local anesthesia debridement intermittent suture with 9 840 yuan. The usage fee is 32 800 yuan. Compared with the use of consumables between the two groups, the cost of consumables in the control group was 12.86 times that of the observation group on the basis of removing free use, which was much higher than that of the observation group. The incision healing time of all patients was (11.96±3.61) d, and the incision healing time of the control group was (11.52±3.22) d, and there was no significant difference in the incision healing time between the two groups (t=0.455, P=0.651). Conclusion Simple VSD has the same irrigation and drainage effect as existing VSD in patients with abdominal trauma infection, and the granulation tissue of the two groups after VSD is grown red, the incision heals well, there is no significant difference in healing time, and the effect is comparable, which promotes the effective healing of infected wounds. However, the cost of using simple VSD consumables is significantly lower than the cost of existing VSD consumables, which reduces the economic burden of patients.
腹部創傷在臨床外科中較為常見，不同程度損傷患者機體血管神經及肌肉等軟組織。若切口發生感染，導致切口愈合延遲，增加腹腔感染風險，嚴重影響患者預后情況，降低醫療服務質量[1-2]?？股丶俺Ｒ帗Q藥治療，是臨床應對腹部創傷感染的主要方法，具有良好的臨床效果，但存在切口暴露、耐藥性等問題，在一定程度上影響臨床效果[3-4]。近年來，隨著醫療技術的不斷發展進步，負壓封閉引流技術（vacuum sealing drainage，VSD）在臨床腹部創傷及感染等的治療過程中具有積極的臨床意義[5]。VSD是通過生物膜將空氣隔離，制造局部密閉空間，控制維持負壓以有效抑制感染，促進創面愈合[6]。VSD操作簡單，可實時觀察監測引流物的形狀及流量等，降低交叉感染風險，縮短臨床療程[7]。本研究將簡易VSD應用于腹部創傷患者感染切口中，旨在探討簡易VSD的臨床應用價值，為臨床干預指導提供科學理論依據。
1 資料與方法
1.1 一般資料 將我院2022年1月至2022年6月收治的50例腹部創傷切口感染患者，按照入院時間先后順序將患者依次編號，按照單雙數隨機分為觀察組25例，對照組25例。觀察組男14例，女11例；年齡22~86歲，平均（48.48±16.75）歲。對照組男14例，女11例；年齡19~68歲，平均（44.28±12.19）歲。兩組患者性別、年齡等一般資料均差異無統計學意義（P＞0.05），具有可比性?；颊叩呐R床資料完整，在《知情同意書》上簽字，所有調查對象的臨床資料遞交倫理委員會審核并獲得批準。