负压封闭引流技术在毒蛇咬伤患者创面治疗中的应用进展

doi:10.3761/j.issn.2096-7446.2023.05.007

摘要/Abstract

摘要： 负压封闭引流（vacuum sealing drainage,VSD）是一种创面治疗方法,临床应用广泛。近年来,VSD在毒蛇咬伤患者创面的治疗中取得了良好的临床效果。该文就VSD的概述及作用机制、毒蛇咬伤VSD的应用方式、应用效果、护理措施、注意事项等方面进行综述,以期为毒蛇咬伤患者创面治疗提供参考。

关键词: 负压伤口疗法, 蛇咬伤, 肿胀, 危重病护理, 综述文献（主题）

Abstract: Vacuum sealing drainage（VSD）is a widely used wound treatment method. In recent years,VSD has achieved good clinical effects in the treatment of venomous snake bites. This paper reviewed the overview and mechanism of VSD,the application mode,application effect,nursing measures and precautions of VSD in venomous snake bite,in order to provide reference for the wound treatment of venomous snake bite patients.

Key words: Negative-Pressure Wound Therapy, Snake Bites, Swelling, Critical Care Nursing, Review Literature as Topic

邓春红, 陶品月. 负压封闭引流技术在毒蛇咬伤患者创面治疗中的应用进展[J]. 中华急危重症护理杂志, 2023, 4(5): 424-429.

DENG Chunhong, TAO Pinyue. Research progress of vacuum sealing drainage technology in wound treatment of venomous snakebite patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(5): 424-429.

参考文献

[1] Arnold C.Vipers,mambas and taipans:the escalating health cri-sis over snakebites[J]. Nature,2016,537(7618):26-28.
[2] 黄明伟,李秀花,孔来法,等. 毒蛇咬伤治疗进展[J]. 中华危重症医学杂志(电子版),2018,11(5):301-303.
Huang MW,Li XH,Kong LF,et al.Progress in the treatment of venomous snake bites[J]. Chin J Crit Care Med Electron Ed,2018,11(5):301-303.
[3] 赵斌,褚庆玉,安玉章,等. 封闭式负压引流技术的临床应用进展[J]. 河北医药,2020,42(9):1402-1407.
Zhao B,Chu QY,An YZ,et al.Research progress on the clinical application of vacuum sealing drain technique[J]. Hebei Med J,2020,42(9):1402-1407.
[4] 张丽,兰频,赖林杰,等. 负压封闭引流在毒蛇咬伤中的临床应用效果[J]. 中国现代医生,2021,59(13):95-98.
Zhang L,Lan P,Lai LJ,et al.Clinical application effect of vacuum sealing drainage in poisonous snake bite[J]. China Mod Dr,2021,59(13):95-98.
[5] 姚苗,马惠珍. 负压封闭引流技术在治疗慢性难愈性创面中的应用进展[J]. 全科护理,2020,18(26):3464-3466.
Yao M,Ma HZ.The application progress of negative pressure wound therapy in the treatment of chronic and refractory wounds[J]. Chin Gen Pract Nurs,2020,18(26):3464-3466.
[6] Padhiyar R,Chavan S,Dhampalwar S,et al.Snake bite envenomation in a tertiary care centre[J]. J Assoc Physicians India,2018,66(3):55-59.
[7] 李其斌,吕传柱,梁子敬,等. 2018年中国蛇伤救治专家共识[J]. 蛇志,2018,30(4):561-567.
Li QB,Lü CZ,Liang ZJ,et al.2018 China expert consensus on the management of snake-bites[J]. J Snake,2018, 30(4):561-567.
[8] 郑志鹏,陈功雷,梁伟,等. VSD负压吸引排毒术在危重型毒蛇咬伤中的临床应用[J]. 中华危重病急救医学,2017,29(11):1026-1029.
Zheng ZP,Chen GL,Liang W,et al.Clinical application of VSD negative pressure aspiration and detoxification in severe snake bite[J]. Chin Crit Care Med,2017,29(11):1026-1029.
[9] 苏海涛,蔡瑀,吴先荣. 自制简便负压封闭引流配合抗蛇毒血清封闭治疗中华眼镜蛇咬伤的研究[J]. 蛇志,2021,33(4):379-381.
Su HT,Cai Y,Wu XR.Curative effect of self-made simple negative pressure sealing drainage combined with antivenom sealing in treatment of Chinese cobra bite[J]. J Snake,2021, 33(4):379-381.
[10] 牟天易,曹小平,阳雪梅,等. 不同治疗方案对蛇咬伤后患肢肿胀的临床疗效比较[J]. 医学信息,2019,32(5):119-120,123.
Mou TY,Cao XP,Yang XM,et al.Comparison of clinical effects of different treatment regimens on swollen limbs after snake bites[J]. Med Inf,2019,32(5):119-120,123.
[11] 曾凡杰. 小切口联合负压创面技术治疗毒蛇咬伤的临床研究[D]. 重庆:第三军医大学,2017.
Zeng FJ.Clinical research on small incisions combined with negative pressure wound therapy after snakebite[D]. Chong-qing:Third Military Medical University,2017.
[12] 穆学伟,吴艺,王盛,等. 创面菱形分布切开联合负压封闭引流技术对毒蛇咬伤的临床价值[J]. 中国现代医学杂志,2020,30(11):112-115.
Mu XW,Wu Y,Wang S,et al.Clinical observation of rhombotomy combined with VSD negative pressure suction for venomous snake bite wound[J]. China J Mod Med,2020,30(11):112-115.
[13] 罗毅,张剑锋,翟崇宇,等. 覆盖式负压封闭引流技术运用于广西竹叶青属毒蛇咬伤的临床研究[J]. 中华危重病急救医学,2020,32(10):1241-1246.
Luo Y,Zhang JF,Zhai CY,et al.Clinical study on the application of covered vacuum sealing drainage technology to the bite of venomous snakes of Trimeresurus stejnegeri in Guangxi[J]. Chin Crit Care Med,2020,32(10):1241-1246.
[14] 刘路培,龙春萍,黄高宗. 波动式负压封闭引流技术对中华眼镜蛇咬伤患者疗效的影响[J]. 中国医药,2021,16(3):444-447.
Liu LP,Long CP,Huang GZ.Influence of vacuum sealing drainage in wave suction on the curative effect of Chinese cobra bites[J]. China Med,2021,16(3):444-447.
[15] Weber WP,Tausch C,Hayoz S,et al.Impact of a surgical seal-ing patch on lymphatic drainage after axillary dissection for breast cancer:the SAKK 23/13 multicenter randomized phase III trial[J]. Ann Surg Oncol,2018,25(9):2632-2640.
[16] 王展福,李雄文,周玉球,等. 改良负压封闭引流技术在眼镜蛇咬伤早期溃疡治疗中的应用研究[J]. 中国基层医药,2018,25(8):953-956.
Wang ZF,Li XW,Zhou YQ,et al.Application of modified negative pressure closed drainage technique in early treatment of cobra bite ulcer[J]. Chin J Prim Med Pharm,2018,25(8):953-956.
[17] 易军,李鹏,吴飞文,等. 生肌愈疡膏联合负压封闭引流治疗蛇伤溃疡20例[J]. 江西中医药大学学报,2022,34(2):34-37.
Yi J,Li P,Wu FW,et al.Clinical observation of Shengji Yuyang Ointment combined with vacuum sealing drainage in treatment of 20 cases of snake wound ulceration[J]. J Jiangxi Univ Chin Med,2022,34(2):34-37.
[18] 陈黎明,黄国亮,吴世浪,等. VSD联合三氧疗法在竹叶青属毒蛇咬伤救治中的应用[J]. 中国急救复苏与灾害医学杂志,2022,17(4):537-540.
Chen LM,Huang GL,Wu SL,et al.Application of VSD combined with ozone therapy in the treatment of snakebite of dracocephalus[J]. China J Emerg Resusc Disaster Med,2022,17(4):537-540.
[19] 陈仪,周伟,黄芷琳. 伤口切开VSD负压引流冲洗对提高眼镜蛇咬伤患者皮肤创面救治成功率的影响[J]. 医学食疗与健康,2022,20(2):9-11,15.
Chen Y,Zhou W,Huang ZL.Effect of wound incision VSD negative pressure drainage irrigation on improving the success rate of skin wound treatment in cobra bite patients[J]. Med Diet Heal,2022,20(2):9-11,15.
[20] 林起庆,何斌,李峥. 小切口负压治疗对竹叶青蛇咬伤后肢体肿胀和凝血功能的影响[J]. 蛇志,2018,30(3):396-398.
Lin QQ,He B,Li Z.Effects of small incisions combined with VSD therapy on Trimeresurus gramineus[J]. J Snake,2018,30(3):396-398.
[21] 刘梦龙,王海燕,周馨,等. 高压氧联合负压创面治疗技术对早期蝮蛇咬伤的疗效观察[J]. 遵义医科大学学报,2022,45(3):383-386.
Liu ML,Wang HY,Zhou X,et al.Clinical research on hyperbaric oxygen combined with negative pressure wound therapy in the treatment of snakebite injury[J]. J Zunyi Med Univ,2022,45(3):383-386.
[22] 朱洪,唐利娟,袁才斌,等. 负压封闭引流技术治疗蛇伤骨筋膜室综合征体会[J]. 蛇志,2017,29(3):386-387.
Zhu H,Tang LJ,Yuan CB,et al.Experience of vacuum sealing drainage technique in the treatment of osteofascial compartment syndrome caused by snake injury[J]. J Snake,2017,29(3):386-387.
[23] 庄增根. 小切口负压治疗毒蛇咬伤后肢体肿胀的效果及对患者炎性因子的影响分析[J]. 中外医学研究,2020,18(28):48-50.
Zhuang ZG.Effect of small incision negative pressure on limb swelling after venomous snake bite and its influence on inflammatory factors in patients[J]. Chin Foreign Med Res,2020,18(28):48-50.
[24] 董文阁. 早期筋膜切开术联合创面负压封闭引流治疗毒蛇咬伤所致筋膜室综合征的研究[D]. 杭州:浙江中医药大学,2022.
Dong WG.Treatment of compartment syndrome caused by venomous snakebites:early fasciotomy combined with vacuum sealing drainage[D]. Hangzhou:Zhejiang Chinese Medical University,2022.
[25] 刘凤,赵国平,秦汉兴,等. 负压封闭引流3种不同负压值对Ⅲ期、Ⅳ期压力性溃疡治疗效果的影响[J]. 护理研究,2018,32(1):123-124.
Liu F,Zhao GP,Qin HX,et al.Influence of 3 different negative pressure values in vacuum sealing drainage on curative effect of stage Ⅲ and Ⅳ pressure ulcer[J]. Chin Nurs Res,2018,32(1):123-124.
[26] 刘小媛,叶健晓,张丽. 冲洗加封闭式负压引流术治疗蛇咬伤的护理[J]. 护理与康复,2017,16(6):641-642.
Liu XY,Ye JX,Zhang L.Nursing of snakebite treated by irrigation plus closed negative pressure drainage[J]. J Nurs Rehabil,2017,16(6):641-642.
[27] 徐袁丁,董训忠,宋晓红,等. 伤口评估三角联合负压封闭引流技术在慢性难愈性创面治疗中的应用[J]. 护理研究,2021,35(14):2582-2584.
Xu YD,Dong XZ,Song XH,et al.Application of wounds international combined with vacuum sealing drainage in treatment of chronic refractory wound[J]. Chin Nurs Res,2021,35(14):2582-2584.
[28] 罗海燕,刘鸣江,谢松林,等. 眼镜蛇咬伤致四肢深层溃疡患者行皮瓣修复的护理[J]. 中华护理杂志,2019,54(8):1201-1204.
Luo HY,Liu MJ,Xie SL,et al.Nursing care of patients with deep ulcer of extremities after cobra injury repaired with skin flaps[J]. Chin J Nurs,2019,54(8):1201-1204.
[29] 周根娣. 多学科诊疗模式下早期分级康复治疗蝮蛇咬伤后肢体肿痛临床观察[J]. 浙江中西医结合杂志,2020,30(1):39-42.
Zhou GD.Clinical observation of early stage rehabilitation in the treatment of limb swelling and pain after adder bite under the mode of multidisciplinary diagnosis and treatment[J]. Zhejiang J Integr Tradit Chin West Med,2020,30(1):39-42.
[30] 杨伟燕,龙春萍,罗毅. 中华眼镜蛇咬伤患者的心理分析及护理策略[J]. 蛇志,2018,30(2):364-365.
Yang WY,Long CP,Luo Y.Psychological analysis and nursing strategy of Chinese cobra bite patients[J]. J Snake,2018,30(2):364-365.
[31] 杨匡,何杨俊,杨树青. 重庆地区1167例毒蛇咬伤的流行病学调查[J]. 创伤外科杂志,2021,23(7):539-541.
Yang K,He YJ,Yang SQ.Epidemiological investigation of 1,167 cases of snake bite[J]. J Trauma Surg,2021,23(7):539-541.