负压封闭引流技术在肛周难愈性感染创面治疗中的应用研究

摘要

目的：观察负压封闭引流技术（VSD）在肛周难愈性感染创面治疗中的应用效果。方法将46例肛周难愈性感染创面患者随机分为2组，观察组23例给予VSD治疗，对照组23例给予常规换药治疗，2组患者创面肉芽生长良好后据具体情况予以创面直接缝合、植皮或转移皮瓣修复。观察比较2组患者抗菌药物应用前及术后第5天的血清降钙素原（ PCT）水平、抗菌药物使用时间、Ⅱ期手术时间、换药次数、McGill疼痛评分、创面愈合时间。结果2组抗菌药物应用前血清PCT水平比较差异无统计学意义（P＞0．05），观察组术后第5天的PCT水平低于对照组（ P＜0．01）。观察组抗菌药物使用时间、Ⅱ期手术时间、创面愈合时间均短于对照组（P均＜0．01），换药次数、McGill疼痛评分均少于对照组（P均＜0．01）。结论 VSD用于肛周难愈性感染创面效果满意，可促进创面愈合，值得临床推广应用。%Objective It is to evaluate the clinical efficacy of vacuum sealing drainage ( vacuum sealing drainage,VSD) in treatment of refractory infected wounds of perianal area .Mteh ods 46 cases with refractory infected wounds of perianal area were randomly divided into two groups.the observation group ( n=23) was treated with vacuum sealing drainage, and the control group ( n=23) was treated with routine dressing change.When the wound granulation of two groups grew well ,the wounds were treated by directly suture,skin graft or transfer of skin flap according to the specific situation.The serum concen-tration of procalcitonin ( PCT) before using antibacterial drugs and the fifth day after surgery, the antibiotic using time, the second stage operation time, the dressing change times, McGill pain score, the wound healing time of the two groups were compared.Results The serum PCT level with two groups before useing antibacterial drugs had no statistical significance ( P>0.05).The serum PCT level of the fifth day after surgery of the observation group was lower than that of the control group , the differences was statistically significant (P<0.01).The antibiotic using time ,the second stage operation time, the wound healing time of the observation group were shorter than those of the control group ,as the dressing change times,McGill pain score of the observation group were less than the control group , the differences were statistically significant (P<0.01).Con -clusion VSD is effective in the treatment of refractory infected wounds of perianal area , it is worthy of clinical application.