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目的探讨应用VSD技术治疗手部烧伤创面中持续冲洗和间断灌洗两种不同处理方法对预防VSD装置失用的效果比较。方法选择2009年2月-2012年2月我院收治的手部烧伤患者80例,随机分成观察组和对照组,每组40例。两组患者均使用相同手术方法及VSD技术治疗。观察组在术后安装VSD装置并接通负压后给予生理盐水接一次性输液器持续冲洗引流,按每日500 ml冲洗量调节滴速,72 h后改为间断冲洗,每日2次。对照组每日4次用注射器抽取生理盐水在各个三通连接处反复挤压灌洗,72 h后改为每日2次。全部VSD装置使用时间平均为7~10 d,负压源统一为医院中心负压。在术后7 d内对2组患者VSD装置使用情况进行比较。结果观察组在术后7 d内共发生VSD装置使用不良事件9例,对照组发生32例,两组比较差异有统计学意义(P<0.05);观察组术后VSD装置使用寿命高于对照组,装置更换率低于对照组,两组差异有统计学意义(P<0.01,P<0.05)。结论应用VSD技术治疗手部烧伤创面患者中采用持续冲洗引流法对降低VSD装置使用不良事件的效果优于间断灌洗法,可降低不良事件的发生率,提高VSD装置的有效性,值得临床推广应用。
Objective To investigate the effect of VSD on the treatment of hand burn wounds by continuous flushing and intermittent lavage. Methods Eighty patients with hand burns in our hospital from February 2009 to February 2012 were randomly divided into observation group and control group, 40 cases in each group. Both groups were treated with the same surgical technique and VSD technique. In the observation group, the VSD device was installed and the negative pressure was applied, then the saline solution was delivered to the disposable infusion set for continuous flushing and drainage. The drip rate was adjusted according to the rinse volume of 500 ml per day. After 72 hours, the device was changed to intermittent flushing twice a day. Control group 4 times a day with a syringe drawn saline repeated squeeze lavage at each tee junction, changed to 2 times a day after 72 h. The average time of using all VSD devices was 7 ~ 10 days, and the negative pressure source unified the hospital center negative pressure. The use of VSD devices was compared between the two groups within 7 days after surgery. Results In the observation group, there were 9 adverse events occurred in the VSD device within 7 days and 32 cases in the control group. There was significant difference between the two groups (P <0.05); the service life of the VSD device in the observation group was higher than that in the control group Group, device replacement rate lower than the control group, the difference between the two groups was statistically significant (P <0.01, P <0.05). Conclusion The application of continuous flushing and drainage method in treatment of patients with hand burn wounds by VSD is better than intermittent lavage in reducing the incidence of adverse events in VSD devices. It can reduce the incidence of adverse events and improve the effectiveness of VSD devices, which is worthy of clinical promotion application.