摘要
目的探讨负压封闭引流技术(VSD)联合银离子冲洗对骨科感染创面愈合及炎性因子表达影响的研究。方法选取我院2018年2月—2020年2月骨科感染创面86例为研究对象,根据治疗方式不同分为观察组和对照组,每组43例。观察组采用VSD+银离子冲洗治疗,对照组采用VSD治疗。比较2组创面愈合、病情改善情况、细菌检出情况及炎性因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)]表达水平。结果观察组创面愈合总有效率高于对照组(P<0.05)。观察组换药次数少于对照组,肉芽组织形成时间、创面愈合时间、住院时间均短于对照组(P<0.01)。治疗2周后,观察组创面病原菌总数、革兰阴性菌所占比例均显著低于治疗前及对照组,对照组创面病原菌总数低于治疗前(P<0.01)。与治疗前比较,2组治疗2周后切口创面评分显著升高,视觉模拟评分显著降低,且观察组变化较对照组显著(P<0.01)。与治疗前比较,2组治疗2周后TNF-α、IL-1、hs-CRP降低,且观察组低于对照组(P<0.01)。结论VSD联合银离子冲洗治疗骨科感染能进一步改善炎症状态、消除病菌,从而促进创面愈合。
Objective To investigate effects of vacuum sealing drainage(VSD)combined with silver ion irrigation on wound healing and expressions of serum inflammatory factors in treatment of patients with orthopedic infection wound.Methods A total of 86 patients with orthopedic infection wounds between February 2018 and February 2020 were selected as research subjects,and the patients were divided into observation group(n=43)and control group(n=43)according to different treatment methods.Observation group was treated with VSD+silver ion irrigation,while control group was treated with VSD.Conditions of wound healing,improvement of pathogenetic condition,detection of pathogens and expressions of inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)]were compared in two groups.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).In observation group,number of dressing changes was less,and formation time of granulation tissues,wound healing time and length of hospital stay were shorter than those in control group(P<0.01).After treatment for 2 weeks,the total number of pathogenic bacteria on the wound surface and the proportion of gram-negative bacteria in observation group were significantly lower than those before treatment and in control group,and the total number of pathogenic bacteria on the wound surface was lower than that before treatment in control group(P<0.01).After treatment for 2 weeks,wound surface scores were significantly higher,while VAS scores were significantly lower than those before treatment in two groups;the changes in observation group were more significant than those in control group(P<0.01).After treatment for 2 weeks,expressions of TNF-α,IL-1 and hs-CRP were significantly lower than those before treatment in two groups,and the expressions in observation group were significantly lower than those in control group(P<0.01).Conclusion VSD combined with silver ion irrigation in treatment of patients with orthopedic infection wounds may further improve the inflammatory state,eliminate pathogens and promote wound healing.
作者
唐天生
邓朝
陈兴爱
谭显春
李彤红
何侨蔚
何芳
TANG Tian-sheng;DENG Zhao;CHEN Xing-ai;TAN Xian-chun;LI Tong-hong;HE Qiao-wei;HE Fang(Department of Orthopaedics,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou,Sichuan 635000,China;Central Hospital of Dazhou City,Dazhou,Sichuan 635000,China)
出处
《解放军医药杂志》
CAS
2021年第8期57-61,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
达州市支撑计划项目(达市财建[2015]61号)。
