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中国临床研究英文版:2021,34(4):493-496
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封闭负压引流技术联合降钙素原动态监测在慢性难愈性创面中的应用
(湛江中心人民医院烧伤整形外科,广东 湛江 524037)
Vacuum sealing drainage technique combined with dynamic monitoring of procalcitonin in chronic refractory wounds
(Department of Burn and Plastic Surgery,Central People′s Hospital of Zhanjiang,Zhanjiang,Guangdong 524037,China)
摘要
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Received:September 02, 2020   Published Online:April 20, 2021
中文摘要: 目的 探讨封闭负压引流技术(VSD)联合动态监测降钙素原(PCT)在慢性难愈性创面(CRW)中的应用价值。方法 选取2018年8月至2020年4月收治的90例CRW患者作为研究对象,采用随机数字表法分为观察组和对照组。对照组45例采用 VSD治疗,观察组45例采用VSD治疗联合PCT动态监测。比较两组的疗效、治疗指标、抗生素使用情况、住院费用和炎性因子水平。结果 观察组(痊愈32例,显效6例,好转5例,无效2例)的疗效明显优于对照组(痊愈21例,显效12例,好转8例,无效4例,u=2.218,P=0.027)。与对照组相比,观察组红期进入时间显著提早,换药次数显著减少,住院时间显著缩短(P<0.05,P<0.01)。观察组入院7 d后的IFN-γ、IL-6、白细胞和hs-CRP水平均高于对照组(P<0.05,P<0.01)。与对照组相比,观察组联用两类及以上抗生素构成比、抗生素升级构成比和抗生素费用显著降低,抗生素疗程显著缩短(P<0.05,P<0.01)。与对照组相比,观察组的检查费用增高,但其他费用、药费和住院总费用显著减少(P<0.05,P<0.01)。结论 VSD联合动态监测PCT用于治疗CRW,可提高疗效,减轻炎症反应,优化抗生素使用方案,降低住院费用。
Abstract:Objective To investigate the application of vacuum sealing drainage (VSD) technique combined with dynamic monitoring of procalcitonin (PCT) in chronic refractory wounds (CRW). Methods Ninety patients with CRW treated from August 2018 to April 2020 were selected as the research objects and randomly divided into observation group and control group(n=45,each).VSD was performed in control group,and VSD combined with dynamic monitoring of PCT was conducted in observation group.The curative effect,therapeutic index,antibiotic usage,hospitalization expense and serum inflammatory factor level were compared between two groups. Results The curative effect in observation group was significantly better than that in control group (u=2.218,P=0.027).Compared with control group,the time for wound surface to enter into the red stage was significantly earlier,the number of dressing changes was significantly less,and the hospital stay was significantly shorter in observation group (P<0.05,P<0.01).At 7 days after admission,the levels of interferon γ (IFN-γ),interleukin 6(IL-6),leukocytes and high sensitivity C-reactive protein (hs-CRP) in observation group were significantly higher than those in control group (P<0.05,P<0.01).Compared with control group,the constituent ratios of combination of two or more antibiotics and upgraded antibiotics and the cost of antibiotics in observation group significantly decreased,and the course of drug use was significantly shortened (P<0.05,P<0.01).Compared with control group,the cost of examination increased,but other expenses,drug costs and total hospitalization costs decreased significantly in observation group (P<0.05,P<0.01). Conclusions VSD combined with dynamic monitoring of PCT can improve the curative effect,reduce the inflammatory response,optimize the use of antibiotics,and reduce the cost of hospitalization in the treatment of CRW.
文章编号:     中图分类号:    文献标志码:B
基金项目:广东省湛江中心人民医院青年扶持基金项目(2020C04)
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