负压封闭引流、自体刃厚皮复合移植联合抗生素骨水泥在四肢难愈性创面中的临床应用研究OA
Clinical Application Research of Vacuum Sealing Drainage,Autologous Split-thickness Skin Grafting Combined with Antibiotic Bone Cement in the Treatment of Refractory Wounds of the Extremities
目的:探讨负压封闭引流、自体刃厚皮复合移植联合抗生素骨水泥在四肢难愈性创面中的临床应用效果.方法:选择广州医科大学附属番禺中心医院于 2024 年 1 月—2025 年 3 月收治的 60 例四肢难愈性创面患者,随机分成对照组(30 例)和试验组(30 例).对照组给予负压封闭引流联合自体刃厚皮复合移植,试验组在对照组的基础上联合抗生素骨水泥治疗.对比两组的换药次数、创面愈合率、住院时间、舒适状况量表(GCQ)评分、VAS评分、CRP、白细胞计数、降钙素原(PCT)、红细胞沉降率(ESR)、ADL评分.结果:试验组换药次数少于对照组,住院时间短于对照组,治疗 2 周后创面愈合率高于对照组(P<0.05).治疗 2 周后,试验组GCQ评分高于对照组,VAS评分低于对照组(P<0.05).治疗 2 周后,试验组CRP、白细胞计数、PCT、ESR低于对照组(P<0.05).治疗 2 周后,试验组ADL评分高于对照组(P<0.05).结论:负压封闭引流、自体刃厚皮复合移植联合抗生素骨水泥在四肢难愈性创面中的临床应用效果确切,能够增加舒适度、改善疼痛,抑制炎症反应、促进创面愈合和提高生活质量.
Objective:To investigate the clinical application efficacy of vacuum sealing drainage,autologous split-thickness skin grafting combined with antibiotic bone cement in the treatment of refractory wounds of the extremities.Method:A total of 60 patients with refractory wounds of the extremities admitted to Panyu Central Hospital,Guangzhou Medical University from January 2024 to March 2025 were selected and randomly divided into a control group(30 cases)and an experimental group(30 cases).The control group was given vacuum sealing drainage combined with autologous split-thickness skin grafting,while the experimental group was treated with antibiotic bone cement on the basis of the control group.The number of dressing changes,wound healing rate,hospital stay,general comfort questionnaire(GCQ)score,VAS score,CRP,white blood cell count,procalcitonin(PCT),erythrocyte sedimentation rate(ESR),and ADL score of the two groups were compared.Result:The number of dressing changes in the experimental group was less than that in the control group,the hospital stay was shorter than that in the control group,and the wound healing rate after 2 weeks treatment was higher than that in the control group(P<0.05).After 2 weeks of treatment,the GCQ score of the experimental group was higher than that of the control group,and the VAS score was lower than that of the control group(P<0.05).After 2 weeks of treatment,the CRP,white blood cell count,PCT,and ESR of the experimental group were lower than those of the control group(P<0.05).After 2 weeks of treatment,the ADL score of the experimental group was higher than that of the control group(P<0.05).Conclusion:The clinical application effect of vacuum sealing drainage,autologous split-thickness skin grafting combined with antibiotic bone cement in the treatment of refractory wounds of the extremities is definite.It can increase comfort,alleviate pain,inhibit inflammatory response,promote wound healing and enhance the quality of life.
周云;崔宏宇;侯雷;冯景浩;王永胜;王波;李军
广州医科大学附属番禺中心医院创伤骨科 广东 广州 511400广州医科大学附属番禺中心医院创伤骨科 广东 广州 511400广州医科大学附属番禺中心医院创伤骨科 广东 广州 511400广州医科大学附属番禺中心医院创伤骨科 广东 广州 511400广州医科大学附属番禺中心医院创伤骨科 广东 广州 511400广州医科大学附属番禺中心医院创伤骨科 广东 广州 511400广州医科大学附属番禺中心医院创伤骨科 广东 广州 511400
医药卫生
抗生素骨水泥负压封闭引流自体刃厚皮复合移植四肢难愈性创面创面愈合
Antibiotic bone cementVacuum sealing drainageAutologous split-thickness skin graftingRefractory wounds of the extremitiesWound healing
《中国医学创新》 2026 (19)
39-43,5
2025年度广东省医学科研基金指令性课题项目(C2025052)2023年番禺区科技计划一般医疗卫生项目(2023-Z04-055)
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