VAC结合游离植皮治疗儿童大面积皮肤缺损疗效观察及对患儿生活质量的影响(1)
[摘要]目的：探討负压创面治疗技术(Vacuum assisted closure，VAC)结合游离植皮治疗儿童大面积皮肤缺损疗效及对患儿生活质量的影响。方法：选取2015年2月-2019年2月笔者医院收治的60例大面积皮肤缺损患儿作为研究对象，按照随机数表法分为干预组和对照组，每组30例。对照组采用游离植皮术治疗，干预组在对照组的基础上结合VAC治疗，以皮片成活时间、皮片成活率、换药次数及住院天数评估疗效，以长海痛尺分级法评估患儿疼痛等级，以抑郁自评量表(Self-rating depression scale，SDS)、焦虑自评量表(Self-rating anxiety scale，SAS)评估患儿心理状态，以术后不良反应发生率评估患儿预后情况，以自制生活质量表评估患儿生活质量水平。结果：干预组患儿皮片成活时间、换药次数与住院天数均小于对照组，差异有统计学意义(P<0.05)。干预组患儿皮片成活率为93.33%高于对照组的76.67%，差异有统计学意义(P<0.05)。干预组治疗后疼痛感、SDS与SAS评分低于治疗前，且低于对照组，差异有统计学意义(P<0.05)。干预组患儿术后不良反应发生率为6.67%显著低于对照组23.33%，差异有统计学意义(P<0.05)。两组治疗前活动能力、心理健康及社交能力均低于治疗后，干预组治疗后活动能力、心理健康及社交能力均高于对照组(P<0.05)。结论：VAC结合游离植皮治疗儿童大面积皮肤缺损疗效显著，能有效降低患儿生理疼痛与心理焦虑，减少伤口感染等不良反应的发生，提高患儿生活质量，具有推广价值。
[关键词]负压创面治疗技术;游离植皮;儿童;皮肤缺损;生活质量;疗效
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2020)05-0093-04
Abstract： Objective To explore the curative effect of vacuum assisted closure (VAC) combined with free skin grafts in the treatment of children with large area skin defects and the influence on quality of life of children. Methods 60 children with large area skin defects who were admitted to the hospital between February 2015 and February 2019 were selected as the subjects. They were divided into the intervention group and the control group by the random number table method， with 30 cases in each group. The control group were treated with free skin grafts. On this basis， the intervention group were additionally treated with VAC. The curative effect was evaluated with the survival time of skin grafts， survival rate of skin grafts， frequency of dressing change and hospital stay. The pain degree was evaluated with the Changhai Pain Rating method， and the psychological status was assessed by the Self-rating depression scale (SDS) and Self-rating anxiety scale (SAS). The prognosis was evaluated with the incidence of postoperative adverse reactions， and quality of life was evaluated with self-made quality of life scale. Results In the intervention group， the survival time of skin flap， the times of dressing change and the days of hospitalization were less than those in the control group， the differences were statistically significant(P<0.05). The survival rate of skin graft in the intervention group was 93.33% higher than thar in the control group(76.67%， P<0.05). The scores of pain， SDS and SAS in the intervention group were lower than those before and in the control group(P<0.05). The incidence of adverse reactions in the intervention group was 6.67%， which was significantly lower than that in the control group(23.33%， P<0.05). The scores of activity ability， mental health and social ability in the two groups before treatment were lower than those after treatment， while those in the intervention group after treatment were higher than those in the control group(P<0.05). Conclusion Vacuum assisted closure (VAC) combined with free skin grafts is significant in the treatment of children with large area skin defects. The combined treatment can effectively reduce physiological pain and anxiety of children， decrease the occurrence of adverse reactions like wound infection， and improve quality of life of children., 百拇医药(张朦 韩涛)
[关键词]负压创面治疗技术;游离植皮;儿童;皮肤缺损;生活质量;疗效
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2020)05-0093-04
Abstract： Objective To explore the curative effect of vacuum assisted closure (VAC) combined with free skin grafts in the treatment of children with large area skin defects and the influence on quality of life of children. Methods 60 children with large area skin defects who were admitted to the hospital between February 2015 and February 2019 were selected as the subjects. They were divided into the intervention group and the control group by the random number table method， with 30 cases in each group. The control group were treated with free skin grafts. On this basis， the intervention group were additionally treated with VAC. The curative effect was evaluated with the survival time of skin grafts， survival rate of skin grafts， frequency of dressing change and hospital stay. The pain degree was evaluated with the Changhai Pain Rating method， and the psychological status was assessed by the Self-rating depression scale (SDS) and Self-rating anxiety scale (SAS). The prognosis was evaluated with the incidence of postoperative adverse reactions， and quality of life was evaluated with self-made quality of life scale. Results In the intervention group， the survival time of skin flap， the times of dressing change and the days of hospitalization were less than those in the control group， the differences were statistically significant(P<0.05). The survival rate of skin graft in the intervention group was 93.33% higher than thar in the control group(76.67%， P<0.05). The scores of pain， SDS and SAS in the intervention group were lower than those before and in the control group(P<0.05). The incidence of adverse reactions in the intervention group was 6.67%， which was significantly lower than that in the control group(23.33%， P<0.05). The scores of activity ability， mental health and social ability in the two groups before treatment were lower than those after treatment， while those in the intervention group after treatment were higher than those in the control group(P<0.05). Conclusion Vacuum assisted closure (VAC) combined with free skin grafts is significant in the treatment of children with large area skin defects. The combined treatment can effectively reduce physiological pain and anxiety of children， decrease the occurrence of adverse reactions like wound infection， and improve quality of life of children., 百拇医药(张朦 韩涛)