经负压封闭装置给药与常规负压封闭引流技术治疗褥疮的临床研究

目的 对比经负压封闭系统给药与常规负压封闭引流两种技术在治疗褥疮上临床效果的差异.方法 2010年5月至2011年12月分别采用经负压封闭给药(给药组)技术治疗与常规封闭负压(VAC组)治疗49例褥疮患者(52处创面),随访时间6~12个月,详细观察两组治疗前后创面变化情况,记录并比较治疗2周前后创面愈合率、创面愈合时间、细菌培养阳性率及发生的并发症等资料.将临床观察及所收集的数据进行统计分析.结果 (1)给药组与VAC组治疗前后14 d创面愈合率分别为(12.8±1.9)%与(7.0±1.2)%,两组创面面积变化有统计学意义(t=13.453,P<0.001).给药组较常规负压封闭引流治疗更能促进创面愈合.(2)给药组与VAC组的愈合时间分别为(31.9±5.8)d与(57.9±17.1)d,两组创面愈合时间差异有统计学意义(t=-3.812,P<0.001).(3)给药组较VAC组相比并发症减少,差异有统计学意义(χ2=4.854,P=0.028).(4)给药组较VAC组细菌培养阳性率降低,差异有统计学意义(χ2=4.688,P=0.030).结论 经负压封闭系统给药技术治疗褥疮能提高创面愈合率,缩短愈合时间,减少并发症和细菌污染,较常规封闭负压治疗更为有效.

Comparing therapies of medicated with vacuum-assisted closure with non medicated in bedsore

Objective Comparing the clinical effect of two therapeutic methods of administration via vacuum-assisted closure to no administration in bedsore.Methods 49 patients with bedsore(52 bedsores)underwent vacuum-assisted closure with medicated therapy(Medication group)and normal vacuum-assisted closure therapy(VAC group)respectively.All patients were followed up for 6-12 months.We recorded and made a contradistinction of each patient’s measurements of wound surface area before and 2 weeks after the treatment,wound healing time,positive rate of bacteria culture and different kinds of complications encountered from May 2010 to December 2011.Then the statistical analysis was performed.Results(1)In the period of 2 weeks after the treatment,medicated therapy can be more benefited to wound healing than vacuum-assisted closure therapy(t=13.453,P<0.001),their healing rates were(12.8±1.9)% and(7.0±1.2)%.(2)The difference of the healing time of two groups was significant(t=-3.812,P<0.001),their healing time were(31.9±5.8)d and(57.9±17.1)d.(3)There was significant difference between two groups in complication incidence(χ2=4.854,P=0.028),medicated therapy lead to fewer complications encountered than vacuum-assisted closure therapy.(4)The positive rate of bacterial culturing on the surface of wound of the VAC group was higher than that of medication group,and the difference was significant(χ2=4.688,P=0.030).Conclusions In this clinical observation we demonstrate the therapy of medicated with vacuum-assisted closure is effective to shorten the healing time,reduce the complication incidence and bacterial culturing on the surface of wound compared to conventional dressing therapy.