摘要
目的探讨双套管持续负压引流在闭合性脱套伤治疗中的应用及临床疗效。方法回顾性分析2009年5月至2010年7月收治的13例闭合性脱套伤患者的临床资料，女11例，男2例；年龄19～57岁，平均32．5岁。所有闭合性脱套伤均为单侧，左侧5例，右侧8例；大转子部5例，大转子及臀部4例，大转子及腰骶部2例，大转子及大腿外侧1例，单纯腰骶部1例。损伤面积，15em x 12cm-45cm x 15cm。除2例延迟诊断者外，其余均在伤后3d内接受手术治疗。手术采用小切口清创引流，术后放置双套管持续负压引流。当24h引流量〈30ml时拔除双套管。愈合标准：损伤局部皮肤无缺血坏死，皮下积液消失，局部触诊皮肤无漂浮感，皮肤与筋膜层之间无相对滑动。结果患者术后4-12d拔除双套管，平均6．3天。13例患者均获得随访，随访时间10-18个月，平均13．7个月。1例患者出现皮肤坏死，经清创、植皮后创面愈合；余12例患者损伤部位的皮下组织均与筋膜层愈合，愈合时间4-10周，平均7．2周。无一例出现深部感染或晚期血源性感染，无全身系统性并发症发生。1例患者置管处切口边缘发生浅表感染，经换药后愈合。结论应用双套管持续负压引流可以有效地治疗闭合性脱套伤，具有安全、微创和经济的优点。
Objective To explore clinical effect of double-tube continuous negative pressure drainage in the treatment of Morel-Lavall6e leision. Methods We retrospectively analyzed the clinical data of 13 patients with Morel-Lavall6e leision, which were diagnosed and treated in our hospital from May 2009 to July 2010. They were 11 women and 2 men, aged from 19 to 57 years （average, 32.5 years）. All patients underwent operations within 3 days after injury, except for 2 patients whose diagnosis was postponed. The operation was performed with small incision and double-tubes were placed for continuous negative pressure drainage. Double-tubes were not removed until effusion was less than 30 ml/24 hours. The heal was defined as no skin necrosis and subcutaneous hydrops at lesion site, no skin floating and sliding at palpation. Re- sults Double-tubes were removed 4 to 12 days postoperatively （average, 6.3 day）. All of 13 patients were followed up for an average of 13.7 months （range, 10 to 18 months）. Skin necrosis occurred in 1 patient. Le- sions were healed 4 to 10 weeks postoperatively（average, 7.2 weeks）. No deep infection or delayed hematoge- nous infection was found. There were no general systematic complications. Superficial infection at wound site occurred in one patient and healed after wound management. Conclusion Application of double-tube contin- uous negative pressure drainage is a safe, less invasive, low-cost and effective treatment for Morel-Lavall6e leision
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2012年第4期339-343,共5页
Chinese Journal of Orthopaedics
关键词
软组织损伤
引流术
治疗结果
Soft tissue injuries
Drainage
Treatment outcome
