持续肝素钠盐水冲洗预防负压封闭引流管阻塞的效果观察

目的探讨持续肝素钠盐水冲洗预防负压封闭引流术(vacuum sealing drainage,VSD)后引流管阻塞的效果。方法采用配对的方法将74例大面积皮肤缺损患者采用VSD治疗的患者分为实验组和对照组,实验组41例,VSD术后24h给予生理盐水250mL+肝素钠12500U(50U/mL),以20~30gtt/min持续滴入创面,每日2次;对照组33例在发生堵管时才用注射器抽取生理盐水20mL注入敷料浸泡,再接通负压反复操作直至VSD通畅为止。比较两组患者VSD使用时间、引流管通畅率、创面愈合时间、组织病理学评分情况。结果两组患者VSD使用时间、引流管通畅率、创面愈合时间、组织病理学评分比较,均P0.05,差异具有统计学意义,实验组患者VSD使用时间明显长于对照组,创面愈合时间明显短于对照组,引流管通畅率明显高于对照组,组织病理学评分明显高于对照组。结论持续肝素钠盐水冲洗法可有效降低VSD堵管发生率,促进创面愈合。

Application of continuous flushing with heparin in the vacuum sealing drainage

Objective To study the effect of continuing flushing with heparin on the prevention of tube obstruction after vacuum sealing drainage（VSD）.Methods Seventy-four patients with large area of skin defects treated by VSD were randomly divided into experiment group and control group. The experiment group were managed by continuous infusion with saline at 250 mL and heparin at 12500 U （50 U/mL）in 24 h after operation,with 20 to 30 drops per minute and two times a day. The control group included 33 cases was injected with 20 mL saline when the drainage tube blocked until the VSD tube was unobstructed. The two groups were compared in terms of drainage time, drainage tube,wound healing time,rate of un-obstruction of tubes and histopathological scores.Results The drainage time and wound healing time of experiment group were significantly shorter than that of control group（P〈0.05）. The rate of un-obstruction of tubes was higher than the control group and so it was with the score in histopathology.Conclusion Continuous flushing with heparin can effectively reduce the incidence of VSD obstruction and promote wound healing.