周康

【摘要】 目的：探讨负压封闭引流（VSD）技术治疗四肢创伤软组织缺损创面患者的效果。方法：选取2017年1月-2018年12月本院收治的四肢创伤软组织缺损创面患者56例，根据临床治疗方法不同将其分为两组，对照组进行常规方法治疗，研究组进行VSD技术治疗。比较两组疗效、植皮所需时间、住院时间、住院花费、植皮成活率、创面愈合率、满意评分、换药次数、创面达到清洁时间、并发症。结果：研究组疗效高于对照组，植皮所需时间、住院时间均短于对照组，住院花费少于对照组，植皮成活率、创面愈合率均高于对照组，满意评分高于对照组，换药次数少于对照组，创面达到清洁时间短于对照组，并发症发生率低于对照组，差异均有统计学意义（P<0.05）。结论：四肢创伤软组织缺损创面治疗中，VSD技术的疗效显著，值得应用。

【关键词】 负压封闭引流技术 四肢 创伤软组织缺损创面 植皮成活 创面愈合

[Abstract] Objective： To explore the effect of vacuum sealing drainage （VSD） in the treatment of traumatic soft tissue defects in limbs. Method： Fifty-six patients with traumatic soft tissue defects in limbs treated in our hospital from January 2017 to December 2018 were selected. They were divided into two groups according to different clinical treatment methods. The control group was treated with conventional methods， the study group was treated with VSD. The curative effect， skin grafting time， hospitalization time， hospitalization cost， skin grafting survival rate， wound healing rate， satisfaction score， dressing change times， wound cleaning time and complications of two groups were compared. Result： The total effective rate of the study group was higher than that of the control group， the time needed for skin grafting and hospitalization were shorter than those in the control group， the hospitalization cost was less than that in the control group， the survival rate of skin grafting and wound healing rate were higher than those in the control group， the satisfaction score was higher than that in the control group， the number of dressing changes in the study group was less than that in the control group， the cleaning time of the wounds was shorter than that in the control group， and the complications rate was lower than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： VSD is effective in the treatment of soft tissue defect of extremities and is worthy of application.

随着我国社会的发展、经济的进步，各种器械与交通导致的意外伤也逐渐增多，四肢严重创伤的发生人数越来越多[1]。四肢创伤发生时一般会伴随大面积皮肤缺损或者是软组织挫伤，且如果不及时接受有效的治疗容易导致创面感染。临床上治疗四肢创伤的常用方法为皮瓣移植覆盖或换药维持创面清洁，但是常规的方法需要的治疗时间长，创面感染难以控制，且创面感染容易导致骨髓炎、骨感染、骨折不愈合等，严重的对患者的肢体功能恢复与保留均造成了影响[2]。因此，寻求更安全、有效的治疗方法尽早对患者的肢体功能进行恢复与保留是非常重要的。近几年，临床上多采用负压封闭引流（VSD）技术治疗四肢创伤软组织缺损创面，该方法可以有效促进创面愈合，减轻组织水肿，效果较好[3]。本院在四肢创伤软组织缺损创面治疗中，使用VSD技术进行治疗，疗效显著，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年1月-2018年12月本院收治的四肢創伤软组织缺损创面患者56例。纳入标准：（1）均符合四肢创伤软组织缺损相关诊断标准;（2）沟通交流能力正常;（3）依从性较好。排除标准：（1）长期服用糖皮质激素;（2）存在免疫系统疾病;（3）存在精神疾病;（4）存在严重的脏器疾病。根据临床治疗方法不同将其分为研究组与对照组，每组28例。该研究已经伦理学委员会批准。