臀上肌肌皮瓣联合负压引流技术治疗骶尾部难治性压疮的疗效观察

摘要

目的:评价臀上肌肌皮瓣联合负压引流技术治疗骶尾部难治性压疮的治疗效果.方法:选择2012年1月-2016年12月于本院住院的骶尾部难治性压疮患者30例,遵照随机双盲原则,分为2组.对照组(15例):单纯应用臀上动脉肌皮瓣修复骶尾部难治性压疮;实验组(15例):应用臀上动脉肌皮瓣联合创面负压引流技术治疗骶尾部难治性压疮.评估两组患者入院后至行肌皮瓣手术修复治疗的天数、手术后至出院天数、总住院天数、术中出血量、术后并发症、住院总费用及复发率等情况.结果:实验组患者入院至手术日天数、术后至出院天数、住院总天数及治疗总费用均少于对照组,差异有统计学意义(P<0.05);但两组间术中出血量、压疮复发率及并发症发生率比较,差异无统计学意义(P>0.05).结论:臀上肌肌皮瓣联合创面负压引流技术治疗骶尾部难治性压疮安全有效、可缩短总住院天数、降低了患者的住院总费用,值得临床推广应用.%Objective To investigate the effiency of superior gluteal myocutaneous flap combined with vacuum sealing drainage technique in the treatment for intractable sacral pressure sore. Methods From January 2012 to December 2016 in our hospital, 30 cases with intractable sacral pressure sore were enrolled, according to a randomized double blind principle, divided into two groups,15 cases in each group. The patients in the control group treated by superior gluteal myocutaneous flap, and the experimental group treated by superior gluteal myocutaneous flap combined with vacuum sealing drainage technique. We had compared the days of admission to the operation, the days of postoperative to discharge from hospital, the total hospitalization days, the intraoperative bleeding, the incidence of postoperative complications, the hospitalization expenses, and the recurrence rate after operation between the two groups. Results The number of days of admission to the operation, the number of days after the operation, the total days of hospitalization and the total cost of treatment in the experimental group were less than those in the control group, and the difference were statistically significant(P<0.05). However, there was no significant difference in the amount of intraoperative bleeding, recurrence rate of pressure sore and the incidence of complications between the two groups(P>0.05). Conclusion Superior gluteal musculocutaneous flap combined with vacuum sealing drainage technique is safe and effective for the treatment of sacrococcygeal refractory pressure sore. It can shorten total hospitalization days and reduce the total hospitalization expenses. It is worthy of clinical application.