摘要
目的观察负压封闭引流(VSD)+持续高锰酸钾冲洗治疗创伤性气性坏疽的临床疗效。方法创伤性气性坏疽病人28例,其中18例行截肢手术,10例行保肢治疗。在截肢术或扩大清创术后,伤口均给予1∶5000的高锰酸钾冲洗联合VSD,对病人治疗前后的病情恢复程度进行评价。结果术后随访10~24个月,平均12个月,所有病人伤口愈合良好,均无复发。1例因严重的糖尿病控制不佳致截肢残端坏死,截肢平面再次升高,术后伤口愈合可;1例病人失血性休克致术中发生心脏骤停,紧急心肺复苏后恢复良好;5例为混合性感染,给予多次扩大清创术控制感染;3例截肢术或扩大清创术后出现严重的疼痛,经治疗后缓解。3例术后发生持续呼吸窘迫症,转入ICU治疗后恢复。结论 VSD联合持续高锰酸钾冲洗是治疗创伤性气性坏疽的有效方法。
Objective The aim of the present study was to use vacuum sealing drainage（VSD）with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical cutative effect and application value. Methods From June 2011 to November 2015,42 patients of traumatic gas gangrene have been treated with this study. There were 22 males and 6 females aged from 17 to 65 years（ mean,37. 9 years）,among which,amputations were done for 27 patients and limb salvage procedures were performed for the others. After amputation or limb salvage procedures,the wound of all patients were disposed of continuous flush of 1：5000 potassium permanganate solution with VSD to control infection. To evaluate the illness recovery degree of all patients after treatment. Results The follow-up visit range from 10 to 24 months（ average 12 months）,none of the patients relapse and the wound healed well. Because of nub necrosis was leaded to serious poorly controlled diabetes,one patient suffering amputation plane to rise again,postoperative wound healing. Cardiac arrest during amputation surgery occurred in one patient who suffered from severe hemorrhagic shock. Recovering well after urgent cardio-pulmonary resuscitation（ CPR）. Five patients suffered from mixed infection,who get well by a second-stage debridement. Three patients suffered from severe pain of the limb after amputation or extensive debridement,who become well after treatment. Three postperative patients suffering ARDS get well by go to ICU. Conclusion Continuous flush of potassium permanganate combined with VSD system is a effective therapy method for traumatic gas gangrene and valuable to used in basic hospital.
出处
《临床外科杂志》
2017年第9期695-697,共3页
Journal of Clinical Surgery
基金
武汉市科技攻关资助项目(201260523172-11)
关键词
气性坏疽
高锰酸钾
冲洗
负压封闭引流
创伤
gas gangrene
potassium permanganate
irrigation
vacuum sealing drainage
trauma
