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目的探讨负压创面治疗技术(negative pressure wound therapy,NPWT)治疗下肢静脉溃疡的临床效果。方法回顾性分析及评价2013年1月至2015年1月在海军总医院行NPWT治疗的39例下肢静脉溃疡创面患者的临床疗效,并行随访。结果患者39例,创面共43处;男27例,女12例;年龄45~79岁;溃疡位于胫前29处,内踝5处,外踝9处;溃疡面积:最大4 cm×8 cm,最小1 cm×2 cm。住院时间:3~6周。13处创面逐渐愈合,未行后期自体游离植皮术;30处创面在肉芽组织覆盖创面后,行自体游离植皮(23处中厚皮片,7处全厚皮片),术后随访6个月,植皮区愈合良好,边缘有少量瘢痕,无明显挛缩;1例患者因下肢被蚊叮咬,再次出现下肢静脉溃疡,于门诊定期换药治疗2个月后创面愈合。结论 NPWT是临床治疗下肢静脉溃疡的有效方法,值得临床推广应用。
Objective To investigate the clinical effect of negative pressure wound therapy (NPWT) on venous leg ulcers. Methods The clinical efficacy of NPWT in 39 patients with venous ulcer of lower extremity treated from January 2013 to January 2015 in our hospital was retrospectively analyzed and evaluated. Results There were 39 patients with 43 wounds. There were 27 males and 12 females, aged 45-79 years old. The ulcers were located at 29 anterior tibiae, 5 at the medial malleolus and 9 at the lateral malleolus. The ulcer area was 4 cm × 8 cm 1 cm × 2 cm. Hospitalization time: 3 to 6 weeks. Thirteen wounds were gradually healed without autograft skin grafts. Thirty wounds were treated with granulation tissue covering the wounds, followed by autologous free skin grafting (23 medium-thickness skin slices and 7 full-thickness skin slices), followed up for 6 months , Skin graft area healed well, a small amount of scar on the edge, no obvious contracture; 1 patient was bites due to mosquitoes of lower extremities, appeared venous leg ulcers again, regular wound dressing in clinic 2 months after wound healing. Conclusion NPWT is an effective method for clinical treatment of venous leg ulcers, worthy of clinical application.