1.The Second Hospital,Cheeloo College of Medicine, Shandong University;2.The Second Hospital of Shandong University
Preparation and application of FITC-chitosan/99Tcm-zoledronic sodium nano-sized Mycobacterium tuberculosis aeroso
摘要 目的 评价清创联合负压辅助创面闭合在骨科的临床效果。 方法 回顾性分析2017年10月-2019年11月本院收治的骨科创伤患者64例，依据术前医患沟通结果，其中32例采用VAC治疗，32例采用常规创面换药治疗，比较两组围手术期、随访与检验结果。 结果 两组均顺利完成二期手术，术中无严重并发症。VAC组初次手术时间稍长，但与常规组差异无统计学意义（P>0.05），VAC组换药次数、渗出评级、肉芽评级、两次手术间隔时间、二次手术时间、创面愈合情况、住院时间等均显著优于常规组（P<0.05）。VAC组的完全负重活动时间显著早于常规组（P<0.05）。随时间推移，两组VAS评分、局部疤痕情况、邻近关节功能均显著改善（P<0.05）。术后3月VAC组上述指标显著优于常规组，差异具有统计学意义（P<0.05）。术后6月、12月两组上述指标的差异均无统计学意义（P>0.05）。检验方面，随时间推移,两组患者的WBC、NEU、CRP和ESR均显著下降（P<0.05）。二次术前VAC组上述指标均显著优于常规组（P<0.05），初次术前和末次随访时两组间各项血液指标的差异无统计学意义（P>0.05）。 结论 清创联合负压辅助创面闭合在骨科治疗中具有简便、安全、高效的应用优势，值得推广应用。
Abstract: [Objective] To evaluate the clinical efficiency of debridement combined with vacuum-assisted closure in orthopedics. [Methods]A retrospective study was conducted on a total of 64 patients who received surgical treatment for orthopedic trauma in our hospital from October 2017 to November 2019. According to preoperative doctor-patient communication，Among them, 32 patients were treated with VAC, and 32 patients were treated with conventional dressing change temporally. The perioperative, follow-up and laboratory results were compared between the two groups. [Results] The two-stage operations were successfully completed in both groups without serious complications. Although the VAC group consumed slightly longer primary operation time, which was not statistically significant compared with the conventional group (P>0.05), The VSD group was significantly better than conventional group in times of dressing change, exudation rating, granulation tissue rating, term of interval for two operations, operation time for secondary, wound healing and hospital stay (P<0.05). The VAC group full weight bearing activity significantly earlier than the conventional group (P<0.05). The VAS score, local scar and adjacent joint function significantly improved over time in both groups (P<0.05), the VSD group was significantly better than the conventional group in abovementioned items at 3 months after operation (P<0.05), there were no statistically significant differences in abovementioned items between the two groups at 6 and 12 months after operation (P>0.05). In terms of blood tests, WBC, NEU, CRP and ESR significantly decreased over time in both groups (P<0.05), the VAC group was significantly better than the conventional group in abovementioned items before the second operation (P<0.05). there were no statistically significant differences in the blood test items between the two groups before the first operation and at the last follow-up (P>0.05). [Conclusion] Debridement combined with vacuum-assisted closure has the advantages of simple, safe and efficient application for treatment of open wound in orthopedics, which is worthy of popularization and application.