基于负压封闭引流技术应用三黄汤灌注 治疗体表脓肿的临床研究
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刘荣朋,男,主治医师,主要从事各类急慢性创面的临床治疗及基础研究工作。

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R 751

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山东省自然科学基金项目(ZR2021MH338);山东省中医药科技项目(2020M170)


Clinical Study on the Treatment of Superficial Abscess with Sanhuang Decoction Based on Vacuum Sealing Drainage
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    摘要:

    摘 要目的:观察负压封闭引流技术(VSD)联合三黄汤灌注对体表脓肿创面的治疗效果。 方法:选取临沂市 人民医院烧伤整形科 2013 年 6 月至 2017 年 2 月期间收治的 72 例体表脓肿患者,采用随机数字表法随机分为 3 组,单 纯中药组、单纯 VSD 组、联合组,各 24 例。单纯中药组患者仅采用三黄汤持续外敷,单纯 VSD 组患者仅采用 0.9 % 氯化钠注射液和 VSD 持续灌注冲洗,联合组患者采用三黄汤和 VSD 持续灌注冲洗。观察各组患者不同时间段创面创 腔面积缩小率、创面肉芽生长情况、疼痛程度及炎症相关检查等指标。 结果:在清创后首次拆除 VSD 或清创后第 5 天、 清创后第 10 天和清创后第 15 天,联合组患者创面创腔面积缩小率均大于单纯中药组和单纯 VSD 组,差异具有统计 学意义(P < 0.05)。在清创后首次拆除 VSD 或清创后第 5 天、清创后第 10 天和清创后第 15 天,联合组患者在创 面肉芽生长评分方面高于单纯中药组和单纯 VSD 组,差异具有统计学意义(P < 0.05)。清创后第 10 天和第 15 天, 联合组患者 VAS 评分均低于单纯中药组和单纯 VSD 组,差异具有统计学意义(P < 0.05)。清创后第 5 天、第 10 天 和第 15 天联合组患者的白细胞(WBC)计数、C 反应蛋白(CRP)水平、红细胞沉降率(ESR)均低于单纯中药组 和单纯 VSD 组,差异具有统计学意义(P < 0.05)。 结论:三黄汤联合 VSD 促进创面愈合效果优于单纯应用三黄汤 外敷或单纯 VSD,为体表脓肿提供了一种简单可行的治疗方法。

    Abstract:

    AbstractObjective To observe the therapeutic effect of vacuum sealing drainage (VSD) combined with Sanhuang decoction perfusion on superficial abscess wound. Methods A total of 72 patients with body surface abscess admitted to the Department of Burn and Plastic Surgery of Linyi People's Hospital from June 2013 to February 2017 were randomly divided into three groups by random number table method: simple Chinese medicine group, simple VSD group and combined group, with 24 cases in each group. Patients in the simple Chinese medicine group were only given continuous external application of Sanhuang decoction, patients in the simple VSD group were only given continuous perfusion irrigation of 0.9 % sodium chloride solution and VSD, and patients in the combined group were given continuous perfusion irrigation of Sanhuang decoction and VSD. The reduction rate of wound area, the growth of wound granulation, the degree of pain and the examination of inflammation were observed. Results After VSD removal for the first time after debridement or on the 5th, 10th and 15th days after debridement, the reduction rate of wound cavity area in the combined group was higher than those in the simple Chinese medicine group and the simple VSD group, the differences were statistically significant (P < 0.05). After VSD removal for the first time after debridement or on the 5th, 10th and 15th days after debridement, the wound granulation growth score of the combined group was higher than those of the simple Chinese medicine group and the simple VSD group, the differences were statistically significant (P < 0.05). On the 10th and 15th days after debridement, the visual analogue scale (VAS) scores in the combined group were lower than those in the simple Chinese medicine group and the simple VSD group, and the differences were statistically significant (P < 0.05). The white blood cell (WBC), C-reactionprotein (CRP) and erythrocyte sedimentation rate (ESR) of the combined group were lower than those of the simple Chinese medicine group and the simple VSD group on the 5th, 10th and 15th days after dedebrination, and the differences were statistically significant (P < 0.05). Conclusion The effect of Sanhuang decoction combined with VSD in promoting wound healing is better than that of simple application of Sanhuang decoction or simple VSD, which provides a simple and feasible treatment method for body surface abscess.

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  • 收稿日期:2023-11-14
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  • 在线发布日期: 2024-06-07
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