苏振国++邱悦++张长丹

【摘要】 目的：通过比较封闭式负压引流技术（VSD）联合阔筋膜张肌肌皮瓣修补术治疗股骨大粗隆压疮与单独使用VSD治疗的效果，探讨VSD联合阔筋膜张肌肌皮瓣修补术在股骨大粗隆压疮治疗中的优越性。方法：选择2010年3月-2013年12月本院治疗的53例股骨大粗隆压疮患者，其中，28例采用VSD联合阔筋膜张肌肌皮瓣修补术（联合组），25例创面采用常规VSD治疗（常规组）。随访3～6个月，对比两种治疗方法在伤口愈合率、住院天数、住院总费用及患者满意度方面的差异。结果：两组伤口愈合率比较差异无统计学意义（P>0.05）；联合组的住院时间及住院总费用均明显少于常规组，患者满意度明显高于常规组，差异均有统计学意义（P<0.05）。结论：VSD联合阔筋膜张肌肌皮瓣修补术治疗股骨大粗隆压疮，与单独使用VSD治疗比较，具有缩短住院时间、降低住院费用及提高患者满意度的优越性。

【关键词】 封闭式负压引流技术； 阔筋膜张肌肌皮瓣修补术； 压疮； 临床疗效

Research of Combined Treatment of Vacuum Sealing Drainage and Tensor Fascia Lata Myocutaneous Flap Transferring on Pressure Ulcers of Trochanteric Osteotomy/SU Zhen-guo，QIU Yue，ZHANG Chang-dan.//Medical Innovation of China，2014，11（16）：028-031

【Abstract】 Objective： To explore the superiority of combined treatment of vacuum sealing drainage （VSD） and tensor fascia lata myocutaneous flap transferring in the treatment of pressure ulcers of trochanteric osteotomy， compared with the VSD-only treatment. Method： A retrospective analysis was performed with 28 cases with combined treatment of vacuum sealing drainage and tensor fascia lata myocutaneous flap transferring （the combined group） and 25 cases with VSD-only treatment （the routine group） from March 2010 to December 2013. All cases were followed up for 3 to 6 months， and the wound healing rate， length of stay， total treatment cost and satisfaction were compared between the two groups. Result： There was no statistically significant difference between the two groupswound healing rate（P>0.05）. The length of stay and the total cost of treatment of the combined group were significantly lower than the routine group， patients satisfaction was significantly higher than the routine group， the differences were statistically significant （P<0.05）. Conclusion： Compared with the VSD-only treatment， combined treatment of vacuum sealing drainage （VSD） and tensor fascia lata myocutaneous flap transferring on pressure ulcers of trochanteric osteotomy has the advantages of short length of stay， low cost， and high patient satisfaction.

【Key words】 Vacuum sealing drainage； Tensor fascia lata myocutaneous flap transferring； Pressure ulcers； Clinical effectiveness

First-authors address：The Haizhu District First People's Hospital of Guangzhou City，Guangzhou 510220，China

doi：10.3969/j.issn.1674-4985.2014.16.009

股骨大粗隆压疮是长期卧床的老龄患者最常见的并发症之一。因其局部营养条件差、易继发感染、入院时已为深度创面等原因，使创面一期修复较为困难。经过几年的临床应用和积极发展，封闭式负压引流技术（VSD）已成为外科多种创面的标准治疗模式[1-3]。其治疗压疮的优势得到认可，目前在压疮治疗上广泛应用[4]。但其存在伤口痊愈时间长、住院费用高的不足之处。针对VSD的不足之处，笔者应用VSD联合阔筋膜张肌肌皮瓣修补术的治疗方法治疗股骨大粗隆Ⅲ、Ⅳ期压疮，效果满意。本科于2010年3月-2013年12月VSD联合阔筋膜张肌皮瓣修补转移术治疗28例股骨大粗隆压疮，并与常规VSD治疗的25例股骨大粗隆压疮进行比较，现报告如下。 ……