负压伤口治疗联合臀上动脉穿支推进皮瓣修复骶尾部压疮(1)
[摘要]目的 探讨负压伤口治疗联合臀上动脉穿支推进皮瓣修复骶尾部压疮的临床效果。方法 选择2015年1月～2016年12月在我院诊断治疗的40例骶尾部压疮患者作为研究对象，采用随机数字表法将其分为对照组、观察组，每组20例。对照组采用单纯的臀上动脉穿支推进皮瓣修复术，观察组采用负压伤口治疗联合臀上动脉穿支推进皮瓣修复术。比较两组患者的手术相关指标和术后复发情况。结果 观察组患者的手术时间与对照组比较，差异无统计学意义(P>0.05)；观察组患者的术中出血量和创面最终愈合时间均少于对照组(P<0.05)；观察组患者的皮瓣成活率显著高于对照组(P<0.05)；术后1年内随访，观察组患者的骶尾部压疮复发率显著低于对照组(P<0.05)。结论 负压伤口治疗联合臀上动脉穿支推进皮瓣修复骶尾部压疮治疗效果显著，术后复发率低，值得推广。
[关键词]负压伤口治疗；臀上动脉穿支推进皮瓣修复术；骶尾部压疮
[中图分类号] R622 [文献标识码] A [文章编号] 1674-4721(2018)2(c)-0031-03
[Abstract]Objective To investigate the clinical effect of negative pressure wound therapy combined with advancing superior gluteal artery perforation flap for the repair of sacrococcygeal pressure sore.Methods 40 patients with sacrococcygeal pressure sores diagnosed and treated in our hospital from January 2015 to December 2016 were selected as the research object.They were divided into control group and observation group by random number table method，with 20 cases in each group.The control group was treated with simple superior gluteal artery perforator flap，while the observation group was treated with negative pressure wound combined with superior gluteal artery perforator flap，compared the two groups of patients with surgical related indicators and postoperative recurrence.Results There was no significant difference in operation time between the observation group and the control group (P>0.05).The amount of bleeding during operation and the time of wound healing in the observation group were less than those in the control group(P<0.05).The survival rate of skin flap in the observation group was significantly higher than that in the control group(P<0.05).After one year of follow-up，the recurrence rate of sacrococcygeal pressure sores in the observation group was significantly lower than that in the control group (P<0.05).Conclusion The treatment of negative pressure wound combined with perforation of the superior gluteal artery perforator repair the sacrococcygeal pressure sore treatment has a significant effect， postoperative recurrence rate is low，it is worth promoting.
[Key words]Negative pressure wound treatment；Supraclavicular artery propulsion flap repair；Sacrococcygeal pressure sore
骶尾部壓疮是长期卧床治疗患者中容易出现的一种并发症，治疗时间长，药物治疗的效果不明显，容易复发，如果没有采取有效的治疗措施，会造成创面的扩大和感染，严重时会出现败血症甚至死亡[1]。负压伤口治疗(NPWT)是近年来兴起的一种急慢性创面的治疗技术，能够有效地清理创面，避免了创面的感染。本文对负压伤口治疗联合臀上动脉穿支推进皮瓣修复骶尾部压疮的疗效进行研究，现报道如下。
1 资料与方法
1.1 一般资料
选择2015年1月～2016年12月在我院诊断治疗的40例骶尾部压疮患者作为研究对象，采用随机数字表法将其分为对照组、观察组，每组20例。本次研究符合相关医学伦理委员会的要求，且所有患者及其家属都签署了知情同意书。观察组男9例，女11例；年龄(60.8±4.5)岁；截瘫或偏瘫原始病程为(6.3±2.1)年；压疮形成时间为(1.7±0.8)年。对照组男8例，女12例；年龄(61.3±4.2)岁；截瘫或偏瘫原始病程为(6.5±2.3)年；压疮形成时间为(1.9±0.6)年。压疮面积8 cm×6 cm～12 cm×10 cm，按照美国国家压疮顾问小组分度标准，21例为Ⅳ度压疮，19例为Ⅲ度压疮。两组患者的一般资料差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(辜为高)
[关键词]负压伤口治疗；臀上动脉穿支推进皮瓣修复术；骶尾部压疮
[中图分类号] R622 [文献标识码] A [文章编号] 1674-4721(2018)2(c)-0031-03
[Abstract]Objective To investigate the clinical effect of negative pressure wound therapy combined with advancing superior gluteal artery perforation flap for the repair of sacrococcygeal pressure sore.Methods 40 patients with sacrococcygeal pressure sores diagnosed and treated in our hospital from January 2015 to December 2016 were selected as the research object.They were divided into control group and observation group by random number table method，with 20 cases in each group.The control group was treated with simple superior gluteal artery perforator flap，while the observation group was treated with negative pressure wound combined with superior gluteal artery perforator flap，compared the two groups of patients with surgical related indicators and postoperative recurrence.Results There was no significant difference in operation time between the observation group and the control group (P>0.05).The amount of bleeding during operation and the time of wound healing in the observation group were less than those in the control group(P<0.05).The survival rate of skin flap in the observation group was significantly higher than that in the control group(P<0.05).After one year of follow-up，the recurrence rate of sacrococcygeal pressure sores in the observation group was significantly lower than that in the control group (P<0.05).Conclusion The treatment of negative pressure wound combined with perforation of the superior gluteal artery perforator repair the sacrococcygeal pressure sore treatment has a significant effect， postoperative recurrence rate is low，it is worth promoting.
[Key words]Negative pressure wound treatment；Supraclavicular artery propulsion flap repair；Sacrococcygeal pressure sore
骶尾部壓疮是长期卧床治疗患者中容易出现的一种并发症，治疗时间长，药物治疗的效果不明显，容易复发，如果没有采取有效的治疗措施，会造成创面的扩大和感染，严重时会出现败血症甚至死亡[1]。负压伤口治疗(NPWT)是近年来兴起的一种急慢性创面的治疗技术，能够有效地清理创面，避免了创面的感染。本文对负压伤口治疗联合臀上动脉穿支推进皮瓣修复骶尾部压疮的疗效进行研究，现报道如下。
1 资料与方法
1.1 一般资料
选择2015年1月～2016年12月在我院诊断治疗的40例骶尾部压疮患者作为研究对象，采用随机数字表法将其分为对照组、观察组，每组20例。本次研究符合相关医学伦理委员会的要求，且所有患者及其家属都签署了知情同意书。观察组男9例，女11例；年龄(60.8±4.5)岁；截瘫或偏瘫原始病程为(6.3±2.1)年；压疮形成时间为(1.7±0.8)年。对照组男8例，女12例；年龄(61.3±4.2)岁；截瘫或偏瘫原始病程为(6.5±2.3)年；压疮形成时间为(1.9±0.6)年。压疮面积8 cm×6 cm～12 cm×10 cm，按照美国国家压疮顾问小组分度标准，21例为Ⅳ度压疮，19例为Ⅲ度压疮。两组患者的一般资料差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(辜为高)