【摘要】 目的 探讨无菌生物护创膜在严重创伤致软组织缺损创面早期治疗中的临床效果。方法 选取2019年1月至2020年12月苏州大学附属第一医院收治的40例严重创伤致软组织缺损患者作为研究对象,按照不同治疗方法将其分为护创膜组(20例)与纱布组(20例),护创膜组患者在对症支持治疗的基础上局部创面早期行无菌生物护创膜联合负压封闭引流治疗,纱布组患者在对症支持治疗的基础上局部创面早期行灭菌凡士林纱布联合负压封闭引流治疗,对比观察两组患者创面疼痛评分、创面基底准备时间、创面愈合时间、住院时间、创面一次性愈合比值以及术后并发症发生情况。结果 护创膜组患者治疗第7天时创面视觉模拟评分法(VAS)评分明显低于纱布组(Z=-2.969,P=0.003),创面基底准备时间、创面愈合时间及住院时间均明显短于纱布组(Z/t=-2.394、-2.782、3.186,P=0.017、0.005、0.003),而创面一次性愈合比值与纱布组无明显差异(χ~2=0.173,P=0.677);护创膜组患者术后并发症发生率为15.0%,与纱布组患者的术后并发症发生率20.0%无明显差异(χ~2=0.173,P=0.677)。结论 无菌生物护创膜可有效减轻严重创伤致软组织缺损创面的疼痛程度,缩短创面基底准备时间、创面愈合时间及住院时间,具有较高的临床应用价值。更多还原

【Abstract】 Objective To study the clinical efficacy of sterile bioprotective film in the early treatment of soft tissue defects caused by severe trauma.Methods 40 patients with soft tissue defects caused by severe trauma admitted to The First Affiliated Hospital of Soochow University from January 2019 to December 2020 were enrolled as the research subjects and divided,based on the treatments they received,into the bioproteetive film group(n=20) and the gauze group(n=20).Based on symptomatic and supportive treatments,the local wounds of patients in the bioprotective film group were treated with sterile bioprotective film combined with vacuum sealing drainage in the early stage,whereas the local wounds of patients in the gauze group were treated with sterilized Vaseline-impregnated gauze combined with vacuum sealing drainage in the early stage.The wound pain score,wound base preparation time,wound healing time,length of stay,ratio of primary healing and the occurrence of postoperative complications were compared between the two groups.Results On day 7 of treatment,the visual analogue scale(VAS) score of patients in the bioprotective film group was significantly lower than that in the gauze group(Z=-2.969,P=0.003),and the wound base preparation time,wound healing time,length of stay were significantly shorter in the bioprotective film group(Z/t=-2.394,-2.782 and 3.186,P=0.017,0.005 and0.003).There was no significant difference between the two groups in terms of the ratio of primary healing(χ~2=0.173,P=0.677).The incidence of postoperative complications was 15.0% in the bioprotective film group,showing no significant difference compared with the 20.0% in the gauze group(χ~2=0.173,P=0.677).Conclusion Sterile bioprotective film can significantly reduce the pain degree of patients with soft tissue defects caused by severe trauma,shorten the wound base preparation time,wound healing time and length of stay,presenting high value of clinical application.更多还原