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负压伤口治疗对牙源性颈部坏死性筋膜炎的影响。

The Effect of NPWT on Odontogenic Cervical Necrotizing Fasciitis.

作者信息

Wang Qian, Yang Xiaolan, Wei Zhiyi, Lin Tianlai, Wang Longfeng

机构信息

Quanzhou Medical College.

Department of Burn Intensive Care Unit, Quanzhou First Hospital.

出版信息

J Craniofac Surg. 2024 Sep 16;36(2):e227-31. doi: 10.1097/SCS.0000000000010564.

DOI:10.1097/SCS.0000000000010564
PMID:39283081
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11845062/
Abstract

OBJECTIVE

To investigate the clinical efficacy of negative pressure wound therapy (NPWT) in the treatment of odontogenic cervical Necrotizing fasciitis (CNF).

METHODS

Sixteen cases of odontogenic cervical necrotizing fasciitis were randomly divided into observation group and control group after routine debridement and disinfection. The patients in the control group were treated with drainage tube and regular dressing changes, while those in the observation group were treated with NPWT. The therapeutic effects of the 2 groups were compared.

RESULTS

The frequency of operation, treatment length, and cost of treatment in the observation group were significantly less than those in the control group (P<0.05). During the treatment, the VAS (visual analog scale of pain) in the observation group was significantly lower than that in the control group (P<0.05). The levels of WBC, CRP, PCT, IL-6, and TNF-α in the observation group were lower than those in the control group (P<0.05). The levels of Il-10 and VEGF in the observation group were higher than those in the control group (P<0.05), the difference was statistically significant.

CONCLUSIONS

The condition of odontogenic cervical necrotizing fasciitis progresses rapidly. Compared with conventional drainage and dressing change, NPWT can control infection in a short time, reduce operation frequency and treatment cost, and promote wound healing, shorten the treatment time, ease the pain of patients, improve the quality of life. The therapeutic scheme is safe, effective, and suitable for clinical application.

摘要

目的

探讨负压伤口治疗（NPWT）在治疗牙源性颈部坏死性筋膜炎（CNF）中的临床疗效。

方法

16例牙源性颈部坏死性筋膜炎患者在进行常规清创和消毒后，随机分为观察组和对照组。对照组患者采用引流管及定期换药治疗，观察组患者采用NPWT治疗。比较两组的治疗效果。

结果

观察组的手术次数、治疗时长及治疗费用均显著少于对照组（P<0.05）。治疗期间，观察组的视觉模拟疼痛评分（VAS）显著低于对照组（P<0.05）。观察组的白细胞（WBC）、降钙素原（CRP）、C反应蛋白（PCT）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平均低于对照组（P<0.05）。观察组的白细胞介素-10（Il-10）及血管内皮生长因子（VEGF）水平高于对照组（P<0.05），差异具有统计学意义。

结论

牙源性颈部坏死性筋膜炎病情进展迅速。与传统的引流及换药相比，NPWT能在短时间内控制感染，减少手术次数及治疗费用，促进伤口愈合，缩短治疗时间，减轻患者疼痛，提高生活质量。该治疗方案安全、有效，适合临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/853dd9b1948b/scs-36-e227-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/2f59f28fc9c6/scs-36-e227-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/9cdefbdeb371/scs-36-e227-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/30c112710034/scs-36-e227-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/2295a67d4821/scs-36-e227-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/853dd9b1948b/scs-36-e227-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/2f59f28fc9c6/scs-36-e227-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/9cdefbdeb371/scs-36-e227-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/30c112710034/scs-36-e227-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/2295a67d4821/scs-36-e227-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/398a/11845062/853dd9b1948b/scs-36-e227-g005.jpg

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