刘志良 李国荣 马华瑞

[摘要] 目的 觀察负压封闭引流VSD技术在口底多间隙感染中的临床应用分析。 方法 将我院2015年1月～2018年12月收治的30例以口底多间隙感染为诊断的患者，随机数字表法分为对照组（15例）与实验组（15例），其中对照组患者以传统切开引流治疗，实验组患者以VSD技术治疗。比较两组患者治疗前、治疗5 d时炎性指标水平、治疗过程中VAS评分、治疗情况（治疗过程中换药次数、抗生素使用时间、住院时间）、并发症及临床疗效。结果 治疗5 d时两组患者炎性指标水平较治疗前明显降低，且实验组明显低于对照组（P<0.01）。在治疗的第2 d、3 d、5 d时实验组患者VAS评分明显低于对照组（P<0.001）。在治疗过程中实验组换药次数明显少于对照组，实验组抗生素使用时间、住院时间均短于对照组（P<0.001）。实验组并发症发生率为6.67%，对照组并发症为33.33%，实验组临床治疗总有效率为100.00%，对照组临床治疗总有效率为73.33%，差异均有统计学意义（P<0.05）。 结论 在口底多间隙感染患者治疗中，以负压封闭引流VSD技术可明显降低患者治疗后的炎性指标水平，减轻患者治疗过程中的疼痛感，减少治疗过程中的换药次数，缩短抗生素使用时间，降低并发症的发生，可获得较好的治疗效果，明显缩短住院时间，效果理想。

[关键词] 负压封闭引流;VSD技术;口底多间隙感染;临床应用

[中图分类号] R781          [文献标识码] B          [文章编号] 1673-9701（2020）17-0120-04

Clinical application of VSD technology in the interspaces infection of the floor of the mouth

LIU Zhiliang   LI Guorong   MA Huarui

Department of Stomatology， Changping District Hospital of traditional Chinese medicine of Beijing Municipality， Beijing  102200， China

[Abstract] Objective To observe and analyze the clinical application of vacuum sealing drainage（VSD） technology in the interspaces infection of the floor of the mouth. Methods 30 patients diagnosed with the interspaces infection of the floor of the mouth admitted to our hospital from January 2015 to December 2018 were divided into the control group（n=15） and the experimental group（n=15） through the random number table method， between which the control group was treated with traditional incision and drainage， and the experimental group was treated with VSD technology. The inflammatory index level before treatment and at 5 d after treatment， VAS scores in treatment， treatment conditions（dressing change times in treatment， antibiotic use time， and hospitalization time）， complications and clinical efficacy of the patients of the two groups were compared. Results The inflammatory index levels in the two groups at 5 d after treatment were significantly lower than those before treatment， and that of the experimental group was significantly lower than that of the control group（P<0.01）. The VAS scores of the experimental group were significantly lower than those of the control group at the 2 d， 3 d and 5 d after treatment（P<0.001）. The dressing change times in treatment of the patients in the experimental group were significantly fewer than those in the control group， and the antibiotic use time and hospitalization time in the experimental group were both shorter than those in the control group（P<0.001）. The incidence of complications of the patients in the experimental group was 6.67%， and that in the control group was 33.33%. The total effective rate of clinical treatment in the patients of the experimental group was 100.00%， and that of the control group was 73.33%， the difference was statistically significant（P<0.05）. Conclusion In the treatment of the patients with interspaces infection of the floor of the mouth， VSD technology can significantly reduce the inflammatory index level of the patients after treatment， ease their pain in treatment， decrease the dressing change times in treatment， shorten the antibiotic use time and lower the occurrence of complications， bringing about better curative effect. As far as its efficacy is concerned， it is satisfying in that it significantly shortens the hospitalization time.

[Key words] Vacuum sealing drainage （VSD）; VSD technology; Interspaces infection of the floor of the mouth/cellulitis of the floor of the mouth; Clinical application

口底多间隙感染（Cellulitis of the floor of the mouth）是一类由混合细菌感染为主的疾病，又称为口底蜂窝组织炎，起病急，发展快，是口腔颌面部最严重且最难治疗的感染之一，主要累及双侧颌下、颏下及舌下间隙[1]。由于其解剖结构特点、细菌感染特性等因素，一般治疗不及时容易引起纵隔及肺部感染、呼吸道阻塞甚至死亡等严重并发症，危及生命，其病死率高达40%～50%[2-3]。基于此，选取我院近期收治的口底多间隙感染患者，采取VSD技术治疗，现报道如下。

1 资料与方法

1.1 一般资料

将我院2015年1月～2018年12月收治的30例以口底多间隙感染为诊断的患者，随机数字表法分为对照组（15例）和实验组（15例）。对照组中，男9例（60%），女6例（40%），年龄19～73岁，平均（47.8±3.5）岁。实验组中，男9例（60%），女6例（40%），年龄22～75岁，平均（48.3±3.7）岁。纳入标准[4]：口底多间隙感染诊断明确者;可配合治疗者;依从性较高者。……