杜康 泮瑩飛 楊新蕾


【摘要】 目的:探究慢性傷口疾病患者應用藻酸鹽類敷料結合創面負壓引流技術的效果。方法:選取2018年8月-2019年1月于筆者所在醫院住院治療的慢性傷口疾病患者60例作為研究對象,利用隨機數字表法將其分為兩組,每組30例。對照組采用傳統負壓引流技術,研究組應用藻酸鹽類敷料結合創面負壓引流技術。比較兩組創面愈合評級、滲出液pH值、傷口愈合時間、傷口換藥次數、換藥費用及1周換藥時疼痛視覺模擬評分法(VAS)評分。結果:研究組創面愈合評級優于對照組,差異有統計學意義(Z=2.970,P=0.003)。研究組滲出液pH值低于對照組,愈合時間短于對照組,換藥次數少于對照組,且換藥費用少于對照組,差異均有統計學意義(P<0.001)。研究組治療1周時VAS評分為(3.2±0.3)分,對照組治療1周時VAS評分為(5.3±0.5)分,兩組比較差異有統計學意義(t=-19.73,P<0.001)。結論:慢性傷口疾病患者應用藻酸鹽類敷料結合創面負壓引流技術利于傷口愈合,能夠提高愈合評級,縮短愈合時間,降低費用和疼痛評分,值得臨床推廣應用。
【關鍵詞】 慢性傷口 藻酸鹽類敷料 創面負壓引流技術 創面愈合
[Abstract] Objective: To explore the effect of alginate dressings combined with wound negative pressure drainage technology in patients with chronic wound diseases. Method: A total of 60 patients with chronic wound diseases hospitalized in our hospital from August 2018 to January 2019 were selected as the research objects. They were divided into two groups by random number table method, with 30 cases in each group. The control group was treated with traditional negative pressure drainage technology, while the study group was treated with alginate dressings combined with wound negative pressure drainage technology. The wound healing rating, exudate pH value, wound healing time, wound dressing change times, dressing change cost and visual analogue score (VAS) score for 1 week dressing change were compared between the two groups. Result: The wound healing rating of the study group was better than that of the control group, the difference was statistically significant (Z=2.970, P=0.003). The pH value of exudate in the study group was lower than that in the control group, the wound healing time was shorter than that in the control group, the times of dressing change was less than that in the control group, and the cost of dressing change was less than that in the control group, the differences were statistically significant (P<0.001). The VAS score of the study group was (3.2±0.3) points at 1 week of treatment, and (5.3±0.5) points of the control group. The difference between the two groups was statistically significant (t=-19.73, P<0.001). Conclusion: The application of alginate dressings combined with wound negative pressure drainage technology is beneficial to wound healing in patients with chronic wound diseases. It can improve the healing rating, shorten healing time, reduce the cost and pain score, and is worthy of clinical promotion and application.
慢性傷口分為靜脈性潰瘍、動脈性潰瘍、創傷性潰瘍、壓力性潰瘍、糖尿病性潰瘍及其他原因導致的創面傷口[1],現階段治療以病因治療為主。在非手術治療中,控制促進愈合是常用手段,但住院時間長、效果不佳感染。患者傷口的病因、大小、身體狀況等都會影響治療結局[2]。目前濕性敷料在慢性傷口中取得較好進展,聯合創面負壓引流技術能夠達到“濕潤愈合”[3]。本文旨在探究慢性傷口疾病患者應用藻酸鹽類敷料結合創面負壓引流技術的效果,現將結果報告如下。
參考文獻
[1]沈曉星,史曉蘭.VR技術聯合新型傷口敷料在老年慢性傷口中的應用價值分析[J/OL].實用臨床護理學電子雜志,2019,4(25):104-105.
[2]溫建明,蔡珍玲.負壓封閉引流技術在慢性傷口中的臨床應用分析[J].中國現代藥物應用,2019,13(10):20-21.
[3]蘇金玲.濕性敷料在慢性傷口中的應用研究進展[J].微創醫學,2019,14(3):364-366.
[4]中華醫學會創傷學分會組織修復學專業委員會.慢性傷口診療指導意見(2011年版)[M].北京:人民衛生出版社,2011:1-34.
[5]楊揚.用TIME傷口床準備聯合封閉式負壓引流法對慢性傷口患者進行傷口護理的效果分析[J].當代醫藥論叢,2019,17(12):257-258.
[6]徐娟,桓雪萊,臧德華,等.給氧負壓傷口治療在骨科慢性傷口中的可行性研究[J].實用骨科雜志,2016,22(12):1083-1086.
[7]胡俊,張玲,鐘紅玲,等.藻酸鹽類敷料聯合自制負壓引流技術在慢性感染傷口護理中的應用效果[J].實用心腦肺血管病雜志:2018,26(z1)364-365.
[8]黃偉,羅云蔓,程中華.VSD聯合微管絲敷料治療脛骨骨折術后難愈創面的療效[J].創傷外科雜志,2019,21(8):620-623.
[9]范欣芳,楊德,馮仕雪.新型濕性愈合敷料在對外傷難愈合傷口患者進行護理中的應用價值[J].當代醫藥論叢,2019,17(6):280-281.
[10]張坤.濕性敷料治療在各種創面治療中的應用進展[J].中國醫療器械信息,2019,25(14):21,123.
[11]賀興,孫家駒,陳天慶,等.負壓封閉引流分別結合藻酸鹽敷料和醫用海綿材料治療難愈性燒傷創面的效果比較[J].中國當代醫藥,2019,26(9):82-84.
[12]申春霞,劉溫溫.探討藻酸鹽類敷料結合創面負壓引流技術以及加強腸道營養在慢性傷口護理中的應用[J].結直腸肛門外科,2018,24(S2):1-2.
[13]張娛.藻酸鹽敷料結合負壓創面治療技術治療腫瘤患者慢性傷口1例的效果分析[J].中國社區醫師,2018,34(10):91.
(收稿日期:2019-10-21) (本文編輯:桑茹南)