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低频电刺激疗法对慢性创面愈合的影响
Effect of low frequency electrical stimulation on chronic wound healing: report of 48 patients
- 第三军医大学学报 2021年43卷第11期 页码：1045-1050
- 作者机构：
646000 四川 泸州，西南医科大学附属医院整形烧伤外科，国家临床重点建设专科，创面修复与再生实验室
- 作者简介：
[颜洪，E-mail：huaxi90@126.com FENG Guang, E-mail: huaxi90@126.com
- 基金信息：
DOI：10.16016/j.1000-5404.202101123
中图分类号： R454.1;R64收稿：2021-01-14，
修回：2021-04-20，
纸质出版：2021-06-15
- 稿件说明：
移动端阅览
田新立, 杨茹茜, 耿康, 等. 低频电刺激疗法对慢性创面愈合的影响[J]. 第三军医大学学报, 2021,43(11):1045-1050.
Xinli TIAN, Ruqian YANG, Kang GENG, et al. Effect of low frequency electrical stimulation on chronic wound healing: report of 48 patients[J]. Journal of Third Military Medical University, 2021, 43(11): 1045-1050.
田新立, 杨茹茜, 耿康, 等. 低频电刺激疗法对慢性创面愈合的影响[J]. 第三军医大学学报, 2021,43(11):1045-1050. DOI： 10.16016/j.1000-5404.202101123.
Xinli TIAN, Ruqian YANG, Kang GENG, et al. Effect of low frequency electrical stimulation on chronic wound healing: report of 48 patients[J]. Journal of Third Military Medical University, 2021, 43(11): 1045-1050. DOI： 10.16016/j.1000-5404.202101123.
摘要
目的
2
探讨逆行岛状腓动脉穿支皮瓣联合Masquelete技术对跟骨骨折术后骨感染伴组织缺损的临床疗效。
方法
2
收集徐州仁慈医院2017年12月至2020年6月跟骨骨折术后骨感染伴组织缺损患者18例，其中男性15例，女性3例，年龄33~64岁，平均42.2岁，修复前骨质缺损2 cm×2 cm×1 cm~ 3 cm×4 cm×3 cm，皮肤软组织缺损5 cm×1 cm~7 cm×2.5 cm。采用分次住院手术的方式：第1次住院予以清创、病灶清除后载抗生素骨水泥填塞骨质缺损、腓动脉穿支皮瓣修复创面。第2次住院取出骨水泥、游离植骨修复骨质缺损。术后观察切口愈合、皮瓣存活情况，监测血降钙素原、C反应蛋白、白介素6等的变化，随访观察评估皮瓣质地变化、骨质愈合、骨感染复发情况。
结果
2
18例患者创面均愈合，其中3例于皮瓣修复术前行2次清创，并辅助以封闭负压引流装置使用。术后各炎症指标均趋向正常，皮瓣均存活良好，各切口均一期愈合。1例患者骨质缺损较浅，骨水泥取出后以富血小板血浆(PRP)凝胶机化填塞骨缺损空腔，未行髂骨植骨。平均住院次数2.13次，人均住院治疗时间31.3 d。随访6~35个月，植骨处骨质愈合满意，无感染复发。
结论
2
利用逆行岛状腓动脉穿支皮瓣联合Masquelete技术治疗跟骨骨折术后骨感染伴组织缺损创面覆盖成功率高，植骨愈合满意，感染控制佳，疗效显著，且手术难度相对较低，易在临床推广。
Abstract
Objective
2
To explore the effect of low frequency electrical stimulation on chronic wound healing.
Methods
2
Forty-eight patients with chronic wounds who were treated in our hospital from September 2017 to September 2020 were enrolled in this study. The course of disease ranged from 31 to 65 d
and there were 15 cases of infectious ulcer
27 cases of diabetic ulcer and 6 cases of connective tissue ulcer. All the patients were treated by following the principle of TIME (wound evaluation
infection control
maintenance of wet balance
promotion of wound edge epithelialization)
and were randomly divided into the observation group and the control group. Besides the routine dressing change given to the both group
those from the observation group were treated with Dutch ultrasound electrotherapy workstation Myomed632VUX (frequency 100 Hz
wave rise ∶wave drop to 3 s ∶3 s
current intensity 15 mA) for 30 min
once a day
5 times per week. The wound healing (eKare inSight 3D Wound Measurement)
infection control and blood perfusion of the wound (PeriScan PIMⅡ Blood Perfusion Imager) before and after each low frequency electrical stimulation were compared between the 2 groups at 3
7
14 and 21 d after treatment.
Results
2
There were significant differences in wound healing between the 2 groups at different time points (
P
<
0.05). The chronic wound healing rate was as high as (87.59±5.81)% in the observation group in 14 d after treatment. Low frequency electrical stimulation resulted in well controlled infection in the observation group at 8.83±5.75 d
which was significantly earlier than that in the control group (12.41±9.52 d
P
<
0.01). At each time of electrical stimulation
the amount of blood perfusion in the wound of the observation group was significantly larger than that in the control group
and continued to increase after being separated from electrical stimulation. And on the 3rd day
the blood perfusion of wound in the observation group was remarkably larger than that in the control group (287.22±13.14
vs
155.20±5.62
PU
P
<
0.01)
and the difference was increased gradually with the elapse of time (
P
<
0.01).
Conclusion
2
Low frequency electrical stimulation can promote chronic wound healing
shorten the time of wound infection control and increase wound blood perfusion.
关键词
Keywords
references
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