灌洗负压持续吸引术在慢性骨髓炎患者中的应用效果(1)
[摘要] 目的 探讨灌洗负压持续吸引术在慢性骨髓炎患者中的应用效果。 方法 选取本院2012年5月～2014年5月收治的60例慢性骨髓炎患者作为研究对象，随机分成观察组和对照组，各30例。两组均给予一般处理和病灶清除术，在此基础上观察组给予伤口灌洗并负压持续吸引治疗，对照组给予传统伤口换药治疗。比较两组的住院时间、伤口愈合及复发情况、护理并发症等。 结果 观察组的住院治疗时间为(21.0±2.67) d，显著短于对照组的(40.0±13.8) d，差异有统计学意义(P<0.05)。观察组的伤口愈合优良率为96.7%，显著高于对照组的56.6%，差异有统计学意义(P<0.05)。观察组的复发率为0%，显著低于对照组的16.7%，差异有统计学意义(P<0.05)。观察组无护理并发症发生，对照组出现1例压疮。 结论 灌洗负压持续吸引术在慢性骨髓炎患者中的应用效果显著，能够促进创面的增生修复，使伤口愈合良好。
[关键词] 病灶清除；灌洗；负压持续吸引；慢性骨髓炎
[中图分类号] R551.3 [文献标识码] A [文章编号] 1674-4721(2015)05(c)-0031-03
[Abstract] Objective To explore the application effect of cleaning by negative pressure in continuous aspiration in patients with chronic osteomyelitis. Methods 60 patients with chronic osteomyelitis from May 2012 to May 2014 in our hospital were selected and randomly divided into the observation group and the control group.General treatment and focus clearance were provided in both groups.The observation group was treated with wound cleaning and continuous aspiration in negative pressure，the control group was treated with traditional wound dressing.The hospital stay，wound healing，recurrence and nursing complication in two groups was compared. Results The hospital stay in the observation group was (21.0±2.67) days，which was shorter than (40.0±13.8) days in the control group，with significant difference(P<0.05).The excellent and good rate of wound healing in the observation group was 96.7%，which was higher than 56.6% in the control group，with significant difference(P<0.05).The recurrence rate in the observation group was 0%，which was lower than 16.7% in the control group，with significant difference(P<0.05).There was no nursing complication occurred in the observation group.There was one case with skin pressure sore in the control group. Conclusion The application effect of cleaning by negative pressure in continuous aspiration in patients with chronic osteomyelitis is significant，which can promote proliferation of wound repair and the wound healed well.
[Key words] Focus clearance；Cleaning；Continuous aspiration in negative pressure；Chronic osteomyelitis
慢性骨髓炎是指患者受伤处骨感染超过6周，多由急性骨髓炎治疗不及时或不当引起，复发率高，治疗周期长，费用高，给患者带来了很大痛苦，同时也是骨科治疗的难题[1]。随着建筑业、交通业、手术治疗的发展，创伤后骨髓炎愈加常见，感染有时长达数月或数年[2]。慢性骨髓炎治疗的方法很多，如病灶彻底清除、肌瓣或肌皮瓣填塞术、开放性松质骨植骨、含抗生素骨水泥充填术、病骨切除术、反复冲洗，中西医治疗、甚至行截肢手术等。本院骨科对慢性骨髓炎患者先进行病灶清除，后采用灌洗并负压持续吸引治疗代替传统的伤口换药治疗，取得了较为满意的效果。
1 资料与方法
1.1 一般资料
选取本院2012年5月～2014年5月收治的60例慢性骨髓炎患者作为研究对象，其中男33例，女27例；发病部位：15例股骨下段，10例股骨中上段，12例胫骨上段，23例胫骨中下段。所有入选患者均有骨手术、外伤、感染病史，病灶均为单病灶，无糖尿病史。将入选患者随机分为观察组和对照组，各30例。观察组中，男18例，女12例；年龄为35～45岁，平均(40±5)岁。对照组中，男15例，女15例；年龄为30～50岁，平均(40±10)岁。两组的病程、年龄、性别、病变部位等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (张梅 喻瑛 杨选花等)
[关键词] 病灶清除；灌洗；负压持续吸引；慢性骨髓炎
[中图分类号] R551.3 [文献标识码] A [文章编号] 1674-4721(2015)05(c)-0031-03
[Abstract] Objective To explore the application effect of cleaning by negative pressure in continuous aspiration in patients with chronic osteomyelitis. Methods 60 patients with chronic osteomyelitis from May 2012 to May 2014 in our hospital were selected and randomly divided into the observation group and the control group.General treatment and focus clearance were provided in both groups.The observation group was treated with wound cleaning and continuous aspiration in negative pressure，the control group was treated with traditional wound dressing.The hospital stay，wound healing，recurrence and nursing complication in two groups was compared. Results The hospital stay in the observation group was (21.0±2.67) days，which was shorter than (40.0±13.8) days in the control group，with significant difference(P<0.05).The excellent and good rate of wound healing in the observation group was 96.7%，which was higher than 56.6% in the control group，with significant difference(P<0.05).The recurrence rate in the observation group was 0%，which was lower than 16.7% in the control group，with significant difference(P<0.05).There was no nursing complication occurred in the observation group.There was one case with skin pressure sore in the control group. Conclusion The application effect of cleaning by negative pressure in continuous aspiration in patients with chronic osteomyelitis is significant，which can promote proliferation of wound repair and the wound healed well.
[Key words] Focus clearance；Cleaning；Continuous aspiration in negative pressure；Chronic osteomyelitis
慢性骨髓炎是指患者受伤处骨感染超过6周，多由急性骨髓炎治疗不及时或不当引起，复发率高，治疗周期长，费用高，给患者带来了很大痛苦，同时也是骨科治疗的难题[1]。随着建筑业、交通业、手术治疗的发展，创伤后骨髓炎愈加常见，感染有时长达数月或数年[2]。慢性骨髓炎治疗的方法很多，如病灶彻底清除、肌瓣或肌皮瓣填塞术、开放性松质骨植骨、含抗生素骨水泥充填术、病骨切除术、反复冲洗，中西医治疗、甚至行截肢手术等。本院骨科对慢性骨髓炎患者先进行病灶清除，后采用灌洗并负压持续吸引治疗代替传统的伤口换药治疗，取得了较为满意的效果。
1 资料与方法
1.1 一般资料
选取本院2012年5月～2014年5月收治的60例慢性骨髓炎患者作为研究对象，其中男33例，女27例；发病部位：15例股骨下段，10例股骨中上段，12例胫骨上段，23例胫骨中下段。所有入选患者均有骨手术、外伤、感染病史，病灶均为单病灶，无糖尿病史。将入选患者随机分为观察组和对照组，各30例。观察组中，男18例，女12例；年龄为35～45岁，平均(40±5)岁。对照组中，男15例，女15例；年龄为30～50岁，平均(40±10)岁。两组的病程、年龄、性别、病变部位等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (张梅 喻瑛 杨选花等)