负压封闭引流技术应用于治疗难治性骨感染

摘要

目的 探讨负压封闭引流(vacuum sealing drainage,VSD)技术辅助应用对难治性骨感染病人创面愈合时间、炎症指标水平及复发率的影响.方法 选取西安医学院附属宝鸡医院骨科2012年1月至2015年6月收治的130例难治性骨感染病人作为研究对象,随机抽签法分为两组:采用常规灌洗法,即对照组(65例);采用VSD技术辅助治疗,即VSD组(65例).比较两组病人创面愈合时间、感染控制时间、换药次数,治疗后白细胞(white blood cell,WBC)、C反应蛋白(C-reactive protein,CRP)水平、红细胞沉降率(erythrocyte sedimentation rate,ESR)水平及随访复发率等.结果 VSD组病人创面愈合时间、感染控制时间及换药次数均显著优于对照组,差异均有统计学意义(均P<0.05).VSD组病人治疗后7 d和14 d炎症指标水平均显著低于对照组,差异均有统计学意义(均P<0.05);VSD组病人术后3个月和6个月的复发率(分别为1.54%、4.62%)显著低于对照组(分别为15.38%、23.08%),差异均有统计学意义(均P<0.05).结论 VSD技术辅助用于难治性骨感染病人治疗可有效加快创面愈合进程,控制炎症反应水平,并有助于降低远期复发风险.%Objective To investigate the effects of vacuum sealing drainage (VSD) technology assisted application on wound healing time, inflammation index levels and recurrence rate of patients with refractory bone infection. Methods One hundred and thirty patients with refractory bone infection were chosen in the period from January 2012 to June 2015 in our hospital and randomly divided into two groups including control group (65 patients) with conventional irrigation method and VSD group (65 patients) with VSD technology assisted application. Wound healing time, infection controlling time, the times of wound dressing, the WBC counts, CRP and ESR after treatment and the recurrence rate of patients were followed up and compared. Results The wound healing time, infection controlling time and the times of wound dressing in VSD group were significantly reduced as compared with those in control group (all P<0.05). The levels of inflammatory indexes at 7th day and 14th day after treatment in VSD group were significantly lower than in control group (all P<0.05). The recurrence rate at 3rd and 6th month after treatment in VSD group was significantly lower than in control group (P<0.05). Conclusion VSD technology assisted application on patients with refractory bone infection can efficiently accelerate the process of wound healing, control the level of inflammatory reaction and be helpful to reduce the long-term risk of recurrence.