改良负压封闭引流技术在眼镜蛇咬伤早期溃疡治疗中的应用研究
Application of modified negative pressure closed drainage technique in early treatment of cobra bite ulcer
目的 观察改良负压封闭引流(VSD)技术在眼镜蛇咬伤早期溃疡患者治疗中的临床效果.方法 选择眼镜蛇咬伤出现早期溃疡患者60例为研究对象,采用随机数字表法分为两组.观察组30例,采用VSD技术结合糜蛋白酶持续冲冼治疗;对照组30例,采用常规换药加压包扎方法治疗.观察两组患者达到二期植皮时间、创面愈合时间、并发症、致残率、住院时间、C反应蛋白(CRP)水平变化,比较治疗效果.结果 观察组并发症、致残发生率分别为0.00%、3.33%,均明显低于对照组的16.67%、26.67%,两组差异均有统计学意义(χ2=4.356、6.405,均P<0.05).观察组3 d、7 d时CRP分别为(15.8±1.7)mg/L、(6.9±1.6)mg/L,对照组分别为(18.6±2.3)mg/L、(13.8±1.9)mg/L,两组差异均有统计学意义(t=5.362、15.214,均P<0.01);观察组二期植皮、创面愈合、住院时间分别为(9.5±1.8)d、(24.0±1.8)d、(25.3±1.9)d,均明显短于对照组的(16.2±2.6)d、(32.0±3.2)d、(33.2±3.7)d,差异均有统计学意义(t=11.604、11.934、10.403,均P<0.01).结论 对于眼镜蛇咬伤早期溃疡患者,采用VSD技术联合糜蛋白酶持续冲洗,可明显降低CRP水平、并发症与致残率,缩短二期植皮时间、创面愈合时间、住院时间,是一种减轻患者痛苦,加速康复的较好治疗方法.
更多Objective To investigate the application of modified negative pressure closure drainage in early stage of snakebite .Methods 60 patients with early bite ulcer were selected as study objects ,and they were randomly divided into two groups according to the digital table .30 patients in the observation group received vacuum sealing drainage(VSD) combined with chymotrypsin continuous rinsing treatment .30 patients in the control group were given conventional dressing bandaging treatment .The two stage skin grafting time,wound healing time,complications,disa-bility rate,hospitalization time and C reactive protein ( CRP) levels of the two groups were observed .And the treatment effect was analyzed .Results The incidence rates of complications and disability in the observation group were 0.00%and 3.33%,respectively,which were significantly lower than 16.67%and 26.67%in the control group ,and the differences between the two groups were statistically significant (χ2 =4.356,6.405,all P<0.05).The CRP levels of 3 d and 7 d in the observation group were (15.8 ±1.7)mg/L,(6.9 ±1.6)mg/L,respectively,which in the control group were (18.6 ±2.3) mg/L,(13.8 ±1.9) mg/L,respectively,there were statistically significant differences between two groups(t=5.362,15.214,all P<0.01).The two stage skin grafting,wound healing,hospital stay of the observation group were (9.5 ±1.8) d,(24 ±1.8) d,(25.3 ±1.9) d,respectively,which were significantly shorter than those of the control group [(16.2 ±2.6)d,(32.0 ±3.2)d,(33.2 ±3.7)d],the differences were statistically significant(t=11.604,11.93410.403,all P<0.01).Conclusion For patients with injury of cobra bite to early ulcer,using VSD technology combined with chymotrypsin continuous irrigation ,can significantly reduce the level of CRP and the occurrence of complications and disability rate ,shorten the time of two stage skin grafting ,wound healing time,hospitalization time,reduce the pain of patients,it is the best treatment to accelerate recovery .
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