摘要
目的探讨自体皮肤移植术联合负压封闭引流技术(VSD)治疗难治性慢性下肢静脉溃疡(VLU)的临床疗效。方法收集2012年3月至2020年9月上海市第六人民医院收治的114例难治性慢性VLU患者的临床资料,根据治疗方式的不同将患者分为观察组(n=53)和对照组(n=61),观察组在常规静脉曲张手术的基础上对VLU创面采取清创术+自体皮肤移植术+VSD,对照组仅采取常规静脉曲张手术+清创术。随访并比较两组患者的溃疡愈合情况。结果两组患者的手术成功率均为100%,围手术期无严重并发症发生。术后2周、4周,观察组VLU的溃疡愈合率均明显高于对照组患者(P<0.01);术后1年,两组患者的溃疡复发率比较,差异无统计学意义(P>0.05)。结论常规静脉曲张手术基础之上的自体皮肤移植术联合VSD技术可以进一步促进难治性慢性VLU创面的愈合,具有较高的临床有效性和安全性。
Objective To evaluate the clinical efficacy of autologous skin transplantation combined with vacuum sealing drainage(VSD)in the treatment of refractory chronic venous leg ulcer(VLU).Method The clinical data of 114 patients with refractory chronic VLU treated in Six People's Hospital of Shanghai from March 2012 to September 2020 were collected.According to different treatment methods,the patients were divided into the observation group(n=53)and the control group(n=61).The observation group adopted debridement and autologous skin transplantation and then VSD on the VLU wound on the basis of routine varicose vein operations,and the control group only adopted routine varicose vein operations and debridement.The ulcer healing of the two groups were followed up and compared.Result The success rate of the two groups was 100%,and there were no serious complications during the perioperative period.The ulcer healing rate in the observation group was significantly better than that in the control group at 2 and 4 weeks after operation(P<0.01),and there was no significant difference in the ulcer recurrence rate at 1 year after operation between the two groups(P>0.05).Conclusion Autologous skin transplantation combined with VSD technology based on conventional varicose vein surgery can further promote the healing of refractory chronic VLU wounds,which has high clinical effectiveness and safety.
作者
张健
郑召同
胡海洋
吴海生
潘烨
邵明哲
赵珺
梅家才
Zhang Jian;Zheng Zhaotong;Hu Haiyang;Wu Haisheng;Pan Ye;Shao Mingzhe;Zhao Jun;Mei Jiacai(Department of Vascular Surgery,Six People's Hospital of Shanghai,Shanghai 200233,China;Department of General Surgery and Pediatric Surgery,People's Hospital of Wulian,Rizhao 262300,Shandong,China)
出处
《血管与腔内血管外科杂志》
2022年第1期70-73,96,共5页
Journal of Vascular and Endovascular Surgery
