摘要
目的观察负压封闭引流技术对重度烧伤伴全身炎症反应综合征（SIRS）的疗效。方法将36名重度烧伤伴SIRS患者，分为治疗组（n=18）和对照组（n=18），治疗组应用负压封闭引流技术治疗创面，每5一，7d更换一次；对照组清创后应用磺胺嘧啶银混悬液外涂于创面，每日更换敷料。比较两组患者术后7d内脓毒症等并发症的发生率、平均每1％全身体表面积（TBSA）烧伤创面的住院费用以及渗出量、人血白蛋白用量和悬浮红细胞用量；分别于术前以及术后24、72、120h，比较两组患者的白细胞计数、中性粒细胞比例以及C反应蛋白（CRP）和降钙素原（PCT）的质量浓度。结果术后，治疗组较对照组并发症发生率低（P〈0．05）。治疗组的1％TBSA住院费用、悬浮红细胞用量、人血白蛋白用量和术后7d内渗出量均显著低于对照组，差异有统计学意义（P〈0．05）。与对照组比较，术后第24h起治疗组患者的白细胞计数、中性粒细胞比例以及CRP和PCT质量浓度均显著降低，差异有统计学意义（P〈0．05）。结论负压封闭引流技术是治疗重度烧伤伴SIRS的有效创面处理方法，能降低脓毒症等并发症的发生率和住院费用。
Objective To observe the therapeutic effect of vacuum sealing drainage in severe burns with the systemic inflammatory response syndrome （SIRS）. Methods A total of 36 cases of severe burn combined with SIRS were divided into treatment group （n = 18） and control group （n = 18）. Vacuum sealing drainage was used for treatment group while the sulfadiazine silver was used for the control group. The incidence of complications, exudation of 1% total body surface area （TBSA）, cost of hospitalization, use of human serum albumin and red blood cell of each group were compared within 7 d after surgery. The leucocyte count, percentage of neutrophile granulocyte, C reactive protein （CRP） and procalcitonin （PCT） were compared between two groups before surgery and at 24, 72, and 120 h after surgery. Results The incidence of complications of treatment group was less than the control group after surgery （P 〈 0.05）. The cost of 1% TBSA hospitalization, consumption of red blood cell and human serum albumin, and exudation within 7 d after surgery were all significantly lower than those of control group, the difference was statistically significant （P 〈 0.05）. The leucocyte count, percentage of neutrophile granulocyte, CRP, and PCT after surgery being performed 24 h were all significantly lower than those of control group, the difference was statistically significant （P 〈 0.05）. Conclusion Vacuum sealing drainage is an efficient method to treat severe burn combined with SIRS. It can reduce the incidence rate of sepsis and other complications and cost of hospitalization.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2014年第2期184-188,共5页
Journal of Shanghai Jiao tong University:Medical Science
基金
郑州市技术研究与开发经费支持项目(083SGHH33297)~~
