| 清创术后持续灌洗加负压封闭吸引引流治疗顽固性软组织及骨与关节感染的临床应用 |
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投稿时间：2009-09-01
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| 作者 | Author | 单位 | Address | E-Mail |
| 杨平林 |
YANG Ping-lin |
西安交通大学医学院附属第二医院骨二科,陕西 西安 710004 |
Department of Orthopaedics,the Second Affiliated Hospital of Xi'an Traffic University,Xi'an 710004,Shaanxi,China |
yplyplypl1974@163.com |
| 贺西京 |
HE Xi-jing |
西安交通大学医学院附属第二医院骨二科,陕西 西安 710004 |
Department of Orthopaedics,the Second Affiliated Hospital of Xi'an Traffic University,Xi'an 710004,Shaanxi,China |
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| 李浩鹏 |
LI Hao-peng |
西安交通大学医学院附属第二医院骨二科,陕西 西安 710004 |
Department of Orthopaedics,the Second Affiliated Hospital of Xi'an Traffic University,Xi'an 710004,Shaanxi,China |
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| 王国毓 |
WANG Guo-yu |
西安交通大学医学院附属第二医院骨二科,陕西 西安 710004 |
Department of Orthopaedics,the Second Affiliated Hospital of Xi'an Traffic University,Xi'an 710004,Shaanxi,China |
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| 臧全金 |
ZANG Quan-jin |
西安交通大学医学院附属第二医院骨二科,陕西 西安 710004 |
Department of Orthopaedics,the Second Affiliated Hospital of Xi'an Traffic University,Xi'an 710004,Shaanxi,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第1期，第1-4页 |
| DOI：10.3969/j.issn.1003-0034.2010.01.001 |
| 基金项目:教育部新教师基金资助项目(编号：20070698073) |
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中文摘要:
目的：应用彻底清创、持续灌洗结合负压封闭吸引引流方法，探讨其治疗顽固性软组织及骨与关节感染的疗效和临床应用价值。
方法：回顾性分析2006年1月至2007年12月诊治的61例顽固性软组织感染、骨髓炎以及关节感染的患者，其中男39例，女22例；年龄10～58岁，平均(35±12)岁。踝部溃疡并感染11例，开放性骨折并骨髓炎15例，骶尾部褥疮并感染9例，人工髋关节置换后感染3例，开放性骨折术后伤口感染5例，皮肤撕脱伤后创面感染18例。病程2周～11个月，平均4个月。采用彻底清创加术后持续灌洗负压封闭引流，结合全身抗生素使用及早期康复训练治疗，通过观察创面愈合速度和时间、真空封闭引流(VSD)敷料更换次数及有无复发等指标来评估疗效。
结果：61例中，踝部溃疡并感染、胫腓骨开放性骨折感染、股骨干骨折感染、骶尾部褥疮并感染、人工髋关节置换术后感染、开放性骨折术后感染和皮肤撕脱伤术后感染平均治疗时间分别为17、36、42、24、32、29、28 d,更换VSD分别为1,2～4,3～5,1～3,2～4,2～3,1～3次。随访1年，除1例股骨干骨折感染患者复发伴外固定钉孔病理性骨折和1例胫腓骨骨折感染复发外，其余患者情况良好，未见有复发的迹象。
结论：清创术后持续灌洗加负压封闭吸引引流能有效地促进顽固性软组织及骨与关节感染伤口的生长与愈合，并缩短感染伤口愈合时间。 |
| 【关键词】清创术 引流术 感染 创伤和损伤 |
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| Clinical application of continuous douche and vacuum sealing drainage in refractory tissue,bone and joint infections after debridement |
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ABSTRACT
Objective: To explore effect and the application value of continuous douche and vacuum sealing drainage(VSD) in refractory tissue,bone and joint infections after complete debridement.
Methods: As retrospective analysis of treatment time and restoration or recurrence,from Jan. 2006 to Dec. 2007,61 cases of refractory tissue,bone and joint infections underwent continuous douche and VSD combined with the treatment of anti-inflammatory and rehabilitation training after debridement in our hospital. The 61 patients included 39 males and 22 females with age ranging from 10 to 58 years with an average of (35±12) years,among whom 61 identified to have ankle ulcers combined with infections,open fracture combined with infections,sacrococcygeal pressure ulcers combined with infections,infections after hip replacement,infections after open fracture,and infections after skin avulsion postoperation were 11,15,9,3,5 and 18 cases respectively. The course was from 2 weeks to 11 months with an average of 4 months.
Results: In all 61 patients,the mean healing time was 17,36,42,24,32,29 and 28 days in ankle ulcers and infections,tibia and fibula open fracture and infections,femoral shaft fracture and infections,sacrococcygeal pressure ulcers and infections,infections after hip replacement,infections after open fracture,and infections after skin avulsion postoperation respectively. The replacement of VSD was 1,2-4,3-5,1-3,2-4,2-3 and 1-3 times in each group respectively. There was no wound recurrence except for 2 cases with recurrent in 61 cases with external fixation nail hole semi-pathological fracture in 1 case of femoral shaft fracture and infection and 1 case of tibia and fibula fracture and infection after follow-up at least one year.
Conclusion: Application of continuous douche and VSD can effectively decrease incidence of complications and promote the refractory tissue,bone and joint infections wound growth,healing and considerably shorten the healing time. |
| KEY WORDS Debridement Drainage Infection Wounds and injuries |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 杨平林,贺西京,李浩鹏,王国毓,臧全金.清创术后持续灌洗加负压封闭吸引引流治疗顽固性软组织及骨与关节感染的临床应用[J].中国骨伤,2010,23(1):1~4 |
| 英文格式: | YANG Ping-lin,HE Xi-jing,LI Hao-peng,WANG Guo-yu,ZANG Quan-jin.Clinical application of continuous douche and vacuum sealing drainage in refractory tissue,bone and joint infections after debridement[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(1):1~4 |
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