骨科创伤合并感染伤口行VSD治疗的护理对策
Nursing countermeasures for VSD treatment of orthopedic trauma and infected wounds.
作者信息
Xu Xin, Sun Yanhua
机构信息
Department of Orthopedics, Huzhou Cent Hosp, Affiliated Cent Hosp Huzhou University Huzhou 313000, Zhejiang, China.
出版信息
Am J Transl Res. 2021 Sep 15;13(9):10625-10632. eCollection 2021.
OBJECTIVE
This study intended to investigate the effect of vacuum sealing drainage (VSD) in the treatment of orthopedic trauma and its role in the clinical care.
METHODS
A total of 104 patients with orthopedic trauma infection admitted to our hospital from January 2019 to January 2020 were divided into control group (n=53, receiving VSD) and study group (n=51, receiving VSD and nursing interventions) by random number table. Surgical outcomes, satisfaction, size of trauma and visual analogue scoring scale (VAS) scores were compared between the two groups.
RESULTS
The study group had shorter time to achieve granulation tissue coverage of wound base, trauma recovery and hospital stay than the control group (<0.05). The satisfaction rate in the study group was higher compared with that in the control group (<0.05). Before intervention, the VAS scores of the two groups and size of trauma were not significantly different (>0.05). After intervention, VAS scores were significantly lower and trauma area was significantly smaller in both groups, and the difference was more pronounced in the study group compared with that in the control group (<0.05). Quality of life scores were higher in the study group compared with the control group (<0.05). Tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were lower in the study group compared with those in the control group (<0.05). Packed cell volume (PCV), plasma viscosity, and low-cut versus high-cut whole blood viscosity were lower in the study group compared with those in the control group (<0.05).
CONCLUSION
VSD treatment combined with clinical nursing interventions in patients with orthopedic trauma infection could shorten the time to granulation coverage, wound healing and hospitalization time, and improve indicators of blood rheology. It could also shrink the size of trauma, decrease the level of pain and inflammatory factors, and improve the quality of life, resulting in high satisfaction.
目的
本研究旨在探讨负压封闭引流（VSD）在骨科创伤治疗中的效果及其在临床护理中的作用。
方法
选取2019年1月至2020年1月我院收治的104例骨科创伤感染患者，采用随机数字表法分为对照组（n = 53，接受VSD治疗）和研究组（n = 51，接受VSD治疗及护理干预）。比较两组的手术效果、满意度、创伤面积及视觉模拟评分量表（VAS）评分。
结果
研究组创面基底肉芽组织覆盖时间、创伤恢复时间及住院时间均短于对照组（<0.05）。研究组的满意度高于对照组（<0.05）。干预前，两组的VAS评分及创伤面积差异无统计学意义（>0.05）。干预后，两组的VAS评分均显著降低，创伤面积均显著减小，且研究组与对照组相比差异更显著（<0.05）。研究组的生活质量评分高于对照组（<0.05）。研究组的肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平低于对照组（<0.05）。研究组的红细胞压积（PCV）、血浆黏度及全血低切与高切黏度均低于对照组（<0.05）。
结论
VSD治疗联合临床护理干预可缩短骨科创伤感染患者的肉芽组织覆盖时间、伤口愈合时间及住院时间，改善血液流变学指标。还可缩小创伤面积，降低疼痛和炎症因子水平，提高生活质量，满意度高。
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