[1]刘旭良,李伯庭,郑介柏,等.负压封闭引流技术联合外用万古霉素治疗骶尾部难愈性压疮的效果[J].医学信息,2022,35(17):37-40.[doi:10.3969/j.issn.1006-1959.2022.17.008]
　LIU Xu-liang,LI Bo-ting,ZHENG Jie-bo,et al.Effect of Vacuum Sealing Drainage Combined with Topical Vancomycin in the Treatment of Sacrococcygeal Refractory Pressure Sores[J].Journal of Medical Information,2022,35(17):37-40.[doi:10.3969/j.issn.1006-1959.2022.17.008]
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负压封闭引流技术联合外用万古霉素治疗骶尾部难愈性压疮的效果()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年17期
页码:
37-40
栏目:
论著
出版日期:
2022-09-01

文章信息/Info

Title:
Effect of Vacuum Sealing Drainage Combined with Topical Vancomycin in the Treatment of Sacrococcygeal Refractory Pressure Sores
文章编号:
1006-1959（2022）17-0037-04
作者:
刘旭良; 李伯庭; 郑介柏; 等
（广州市第十二人民医院骨科，广东 广州 510620）
Author(s):
LIU Xu-liang; LI Bo-ting; ZHENG Jie-bo; et al.
(Department of Orthopedics,Guangzhou Twelfth People’s Hospital,Guangzhou 510620,Guangdong,China)
关键词:
万古霉素; 压迫性溃疡; 封闭负压引流技术
Keywords:
Vancomycin; Pressure sores; Vacuum sealing drainage technique
分类号:
R632.1
DOI:
10.3969/j.issn.1006-1959.2022.17.008
文献标志码:
A
摘要:
目的 观察负压封闭引流（VSD）联合万古霉素治疗骶尾部难愈性压疮的效果。方法 选取广州市第十二人民医院2014年1月-2020年6月创面分泌物细菌培养结果为革兰氏阳性菌感染的骶尾部难愈性压疮患者60例为研究对象，按照处理创面的方式分为A、B、C三组，每组20例。A组采用VSD联合外用万古霉素治疗，B组单纯应用VSD治疗，C组采用传统换药治疗。比较三组治疗前后创面面积缩小比例、肉芽增大比例、BWAT评分变化及创面分期变化。结果 三组创面面积缩小程度比较，差异有统计学意义（P＜0.05），其中创面面积缩小程度：A组＞B组＞C组；三组肉芽增大比例比较，差异有统计学意义（P＜0.05），其中肉芽增大比例：A组＞B组＞C组；三组BWAT评分降低程度比较，差异有统计学意义（P＜0.05），其中BWAT评分降低程度：A组＞B组＞C组；三组创面分期变化比较，差异无统计学意义（P＞0.05）。结论 外用万古霉素可应用于骶尾部难愈性压疮的治疗，联合应用VSD相对其他治疗方式具有一定优势。
Abstract:
Objective To observe the effect of vacuum sealing drainage (VSD) combined with vancomycin in the treatment of sacrococcygeal refractory pressure sores.Methods From January 2014 to June 2020, 60 patients with sacrococcygeal refractory pressure sores infected by Gram-positive bacteria were selected from the bacterial culture results of wound secretions in Guangzhou Twelfth People’s Hospital as the research objects. According to the way of wound treatment, they were divided into three groups: A, B and C, with 20 cases in each group. Group A was treated with VSD combined with topical vancomycin, group B was treated with VSD alone, and group C was treated with traditional dressing change. The changes of wound area reduction ratio, granulation enlargement ratio, BWAT score and wound staging before and after treatment were compared among the three groups.Results There were significant differences in the degree of area reduction among the three groups (P<0.05), and the degree of area reduction was group A>group B>group C. There was significant difference in the proportion of granulation enlargement among the three groups (P<0.05), and the proportion of granulation enlargement was group A>group B>group C. There was significant difference in the degree of BWAT score reduction among the three groups (P<0.05), and the degree of BWAT score reduction was group A>group B>group C. There was no significant difference in wound stage among the three groups (P>0.05).Conclusion Topical vancomycin can be used in the treatment of sacrococcygeal refractory pressure sores, and the combined application of VSD has certain advantages over other treatment methods.

参考文献/References:

[1]Artico M,Dante A,D’Angelo D,et al.Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: A retrospective chart review[J].Palliat Med,2018,32(1):299-307．[2]中国老年医学学会烧创伤分会,中国医师协会中国创面修复科标准化建设专家委员会,全国创面修复专科联盟.创面修复科医师职业标准的全国专家共识[J].感染、炎症、修复,2020,21(3):131-134.[3]李佩芳,宁宁,陈佳丽,等.Bates-Jensen伤口评估与效果评价量表在治疗慢性伤口中的应用[J].华西医学,2015,30(10):1835-1837.[4]褚万立,郝岱峰.美国国家压疮咨询委员会2016年压力性损伤的定义和分期解读[J].中华损伤与修复杂志（电子版）,2018,13(1):64-68.[5]郝振明,雷晋,张海瑞,等.慢性难愈创面的综合性治疗分析[J].中国药物与临床,2021,21(9):1520-1521.[6]王欣,梁尊鸿,黄阳君,等.多部位难愈性压疮的个体化序贯性治疗[J].中华损伤与修复杂志（电子版）,2019,14(4):300-302.[7]梁尊鸿,潘云川,陈贻梆,等.修复老年患者全身多部位难愈性压疮十例[J].中华烧伤杂志,2018,34(2):120-121.[8]倪俊,许献荣,陈瑞彩.老年难愈性创面患者临床特征及创面细菌学分析[J].中国微生态学杂志,2019,31(9):1064-1067.[9]陈兴阳,陈雷,吉希杰.感染性慢性难愈合创面病原菌分布特点及耐药性分析[J].中国烧伤创疡杂志,2021,33(2):86-90.[10]张能华,沈惠,陈兴英,等.耐甲氧西林金黄色葡萄球菌耐药特性及生物膜形成能力分析[J].中国卫生检验杂志,2019,29(22):2728-2730,2734.[11]符秀梅,钟书辉,薛根山,等.Ⅳ期压疮感染患者的临床特征、病原菌分布及耐药性分析[J].湖南师范大学学报（医学版）,2020,17(2):85-89.[12]刘晓玲,丁宸,陈永刚,等.万古霉素在42例金黄色葡萄球菌感染患者中的疗效及与其最低抑菌浓度分析[J].中华危重症医学杂志（电子版）,2019,12(1):42-45.[13]侯喜琴,赵云勋,郑燕青,等.莫匹罗星、利奈唑胺、万古霉素和替加环素对MRSA的体外活性研究[J].中国实验诊断学,2014,(10):1592-1594.[14]聂昌韦,余峰,邓伟,等.抗生素骨水泥联合皮瓣修复术对促进糖尿病足踝部创面康复的作用[J].反射疗法与康复医学,2020,1(19):88-90.[15]毛璐,张伯松,姜璐,等.载万古霉素骨水泥的人体局部释放及全身药物浓度监测[J].中国医院药学杂志,2019,39(3):244-246.[16]郭旭锋,刘勇军,高宏伟,等.万古霉素复合型抗菌药物骨水泥植入术疗法对骨科术后感染的疗效[J].中华实验和临床感染病杂志（电子版）,2018,12(2):189-192.[17]孙杰,诸利刚,李宏烨,等.糖尿病足感染病原学及其万古霉素联合骨水泥注射治疗效果[J].中华医院感染学杂志,2021,31(1):24-27.[18]王子田,杨彪,李欣,等.万古霉素骨水泥治疗胫骨慢性骨髓炎[J].中国矫形外科杂志,2019,11:1052-1053.[19]王刚,章乐成,严超,等.Ilizarov技术结合载万古霉素骨水泥治疗胫骨创伤后骨感染合并骨与软组织缺损的疗效[J].中华创伤杂志,2021,37(3):210-215.[20]周小斌,谢林海,陈小波,等.负压封闭引流术对Ⅲ、Ⅳ期压疮感染创面血管神经生成的影响[J].赣南医学院学报,2020,40(11):1115-1119.

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更新日期/Last Update: 1900-01-01