微动力负压技术治疗小面积Ⅲ度低热烧伤创面的临床疗效观察

doi:10.3877/cma.j.issn.1673-9450.2020.06.007

目的

观察微动力负压技术(micro-dynamic negative pressure wound therapy, MDNPWT)应用于小面积Ⅲ度低热烧伤创面的临床疗效。

方法

收集2016年1月至2018年5月于海军军医大学第一附属医院烧伤外科门诊就诊的小面积(≤10 cm²)Ⅲ度低热烧伤患者220例。应用MDNPWT治疗的108例患者设为微动力负压组，采用常规治疗的112例患者设为常规治疗组。微动力负压组患者入组后采取持续微动力负压护创敷料换药，而常规治疗组采用传统的外用药物治疗。对比微动力负压组和常规治疗组的创面愈合时间、换药次数、治疗总费用及手术率。对数据行t检验和χ²检验。

结果

微动力负压组和常规治疗组的创面愈合时间分别为(31.8±3.5)、(48.0±13.9) d，2组比较差异有统计学意义(t＝11.75，P<0.05)；微动力负压组和常规治疗组的换药次数分别为(6.4±0.7)、(34.2±3.1)次，2组比较差异有统计学意义(t＝18.76，P<0.05)；微动力负压组和常规治疗组治疗总费用分别为(2 807.5±782.6)、(7 516.7±238.3)元，2组比较差异有统计学意义(t＝18.55，P<0.05)；微动力负压组和常规治疗组的手术率分别为0、70.5%，2组比较差异有统计学意义(χ²＝118.9，P<0.05)。

结论

MDNPWT具有缩短创面愈合时间、减少换药次数、节省治疗总费用及降低小面积深度烧伤创面手术率等优点。因此，MDNPWT可以作为小面积Ⅲ度低热烧伤创面治疗安全有效的新方法。

关键词: 烧伤, 创伤和损伤, 负压伤口疗法, 微动力

Objective

To summarize the clinical effect of micro-dynamic negative pressure wound therapy(MDNPWT) on small area full thickness burn wounds caused by low-heat.

Methods

Clinical data of 220 outpatients with small area full thickness burn wounds caused by low-heat from Jan, 2016 to May, 2018 in Department of Burns Surgery, First Affiliated Hospital, Naval Medical University were collected. One hundred and eight patients treated with MDNPWT were set as micro-dynamic negative pressure group. One hundred and twelve patients treated with conventional treatment were set as conventional treatment group. MDNPWT wound dressing were used for dressing change in micro-dynamic negative pressure group, while classic wound dressing were used for dressing change in conventional treatment group. Healing time, frequency of dressing change, total costs, surgery rates of the 2 groups were compared. Data were processed with t test and chi-square test.

Results

The healing time in the micro-dynamic negative pressure group and conventional treatment group were (31.8±3.5), (48.0±13.9) d, the difference was statistically significant (t=11.75, P<0.05). The average times in the micro-dynamic negative pressure group and conventional treatment group were (6.4±0.7), (34.2±3.1) times, the difference was statistically significant (t=18.76, P<0.05). Total costs in the micro-dynamic negative pressure group and conventional treatment group were (2 807.5±782.6), (7516.7±238.3) yuan, the difference was statistically significant(t=18.55, P<0.05). Surgery rates in the micro-dynamic negative pressure group and conventional treatment group were 0 and 70.5%, the difference was statistically significant (χ²=118.9, P<0.05).

Conclusion

MDNPWT can be used as a new method to treat full thickness burn wounds caused by low-heat as it shows advantages in shortening wound healing time, saving treatment costs, lowing dressing change frequency and surgery rate.

Key words: Burns, Wounds and injuries, Negative pressure wound therapy, Micro-dynamic

表1 微动力负压治疗组与常规治疗组小面积Ⅲ度低热烧伤患者一般资料

组别	例数	年龄(岁，±s)	性别(例)		致伤因素(例)		受伤至入组时间(d, ±s)	创面面积(cm², ±s)
组别	例数	年龄(岁，±s)	男	女	热水袋低温烫伤	艾灸低温烫伤	受伤至入组时间(d, ±s)	创面面积(cm², ±s)
微动力负压组	108	47.2±1.3	34	74	76	32	2.09±0.09	6.19±0.17
常规治疗组	112	46.7±1.4	41	71	84	28	1.91±0.08	5.94±0.15
t值		0.2880					1.452	1.134
χ²值			0.643		0.594
P值		0.774	0.423		0.442		0.074	0.258

表1 微动力负压治疗组与常规治疗组小面积Ⅲ度低热烧伤患者一般资料

组别	例数	年龄(岁，±s)	性别(例)		致伤因素(例)		受伤至入组时间(d, ±s)	创面面积(cm², ±s)
组别	例数	年龄(岁，±s)	男	女	热水袋低温烫伤	艾灸低温烫伤	受伤至入组时间(d, ±s)	创面面积(cm², ±s)
微动力负压组	108	47.2±1.3	34	74	76	32	2.09±0.09	6.19±0.17
常规治疗组	112	46.7±1.4	41	71	84	28	1.91±0.08	5.94±0.15
t值		0.2880					1.452	1.134
χ²值			0.643		0.594
P值		0.774	0.423		0.442		0.074	0.258

表2 微动力负压治疗组与常规治疗组小面积Ⅲ度低热烧伤治疗结果相关指标

组别	例数	创面愈合时间(d, ±s)	换药次数(次，±s)	平均治疗总费用(元，±s)	手术率[例(%)]
微动力负压组	108	31.8±3.5	6.4±0.7	2 807.5±782.6	0(0)
常规治疗组	112	48.0±13.9	34.2±3.1	7 516.7±238.3	79(70.5)
t值		11.75	18.76	18.55
χ²值					118.9
P值		<0.05	<0.05	<0.05	<0.05

表2 微动力负压治疗组与常规治疗组小面积Ⅲ度低热烧伤治疗结果相关指标

组别	例数	创面愈合时间(d, ±s)	换药次数(次，±s)	平均治疗总费用(元，±s)	手术率[例(%)]
微动力负压组	108	31.8±3.5	6.4±0.7	2 807.5±782.6	0(0)
常规治疗组	112	48.0±13.9	34.2±3.1	7 516.7±238.3	79(70.5)
t值		11.75	18.76	18.55
χ²值					118.9
P值		<0.05	<0.05	<0.05	<0.05

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Clinical effect of micro-dynamic negative pressure wound therapy on small area full thickness burn wounds caused by low-heat

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Clinical effect of micro-dynamic negative pressure wound therapy on small area full thickness burn wounds caused by low-heat