目的分析负压封闭引流技术在不同创面序贯救治中的应用情况,探讨负压封闭引流对血压、血液指标的影响,为规范化开展负压封闭引流技术提供临床应用依据。方法选取2009年5月—2015年11月成都医学院第一附属医院烧伤整形科收治的35例创伤所致皮肤软组织缺损、无法一期手术封闭的患者,采用“简单清创-负压封闭引流-二期手术”的序贯治疗方式,进行治疗。根据具体伤情变化制定负压封闭引流时间,每3~7 d更换敷料,观察创面改善进展;根据具体创伤情况制定二期皮肤或皮瓣移植手术方式,同时进行血压、血液学指标的监测。结果所有创面在简单清创并负压封闭引流后逐渐形成新鲜肉芽,无脓性渗出,创面面积逐渐缩小;29例患者经过1次皮肤或皮瓣移植手术后治愈,6例患者经过2次皮肤或皮瓣移植手术治愈;1例负压吸引面积达10%的患者在清创-负压封闭引流术后血红蛋白由117 g/L降至61 g/L,给予对症支持处理,保持负压封闭引流,随后患者血红蛋白逐渐上升,经负压封闭引流2周、植皮术后3周,创面愈合。结论 “简单清创-负压封闭引流-二期手术”的序贯救治方案为皮肤软组织缺损、无法一期手术封闭的创伤患者提供了一项简便可行、疗效确切的治疗方法,避免伤口感染,促进创面愈合;对于负压封闭引流面积达10%的患者,首次清创可能会影响血液学指标变化,但处于可控范围之内,负压吸引过程对血液指标以及血压的影响不大。 Objective To analyze the application of negative pressure closed drainage in sequential wound healing of different wounds, and to explore the effect of negative pressure closed drainage on blood pressure and blood index, so as to provide the clinical application basis for standardizing negative pressure closed drainage. Methods From May 2009 to November 2015, 35 cases of skin and soft tissue defects caused by trauma were treated in the Department of Burns and Plastic Surgery, the First Affiliated Hospital of Chengdu Medical College. Patients who could not be closed in the first stage were treated with “simple debridement - Drainage - two surgical ”sequential treatment, treatment. According to the specific changes of injury to develop negative pressure drainage time, every 3 ~ 7 d dressing replacement, to observe the wound to improve the progress; according to the specific trauma situation to develop two skin or skin flap surgery, at the same time, blood pressure, hematology monitoring indicators. Results All of the wounds formed fresh granulation gradually after simple debridement and closed drainage with negative pressure. No purulent exudation occurred. The wound area was gradually reduced. Twenty-nine patients were cured after one skin or flap transplant and six patients were treated twice Skin or skin graft surgery was cured. One patient with negative pressure of 10% had hemoglobin reduced from 117 g / L to 61 g / L after debridement-negative pressure drainage and drainage, given symptomatic supportive treatment and maintained negative pressure Closed drainage, followed by patients with hemoglobin gradually increased, closed by negative pressure drainage for 2 weeks, 3 weeks after skin grafting, wound healing. Conclusions The sequential treatment of simple debridement-negative pressure closed drainage-second-stage operation provides a simple and effective curative treatment to patients with traumatic skin and soft tissue defects who can not be closed surgically and avoid wounds Infection, promote wound healing; for patients with negative pressure closure drainage area of ​​10%, the first debridement may affect hematological changes, but within the controllable range, negative pressure on the blood index of the process of induction and blood pressure is not big .