摘要
目的探讨神经内科压疮患者适宜的清创方法及其效果。方法按入选标准选择神经内科压疮患者48例74处Ⅱ-Ⅳ期压疮,分为3组,即自溶清创组(24处)、保守性锐器清创组(24处)和联合清创组(26处),按操作流程分别评估和清创,清创后均给予水胶体敷料、油纱等覆盖至愈合。从初诊至治疗结束,全程给予气垫床减压、每2h翻身1次、经口或鼻饲管营养支持、活动和皮肤护理指导等全身干预。记录3组的压疮愈合计分、清创期时间和愈合时间,使用单因素方差分析比较3组的结果。结果自溶清创、保守性锐器清创和联合清创3种清创方法的清创期时间分别为(34.29±17.88)d、(20.88±10.30)d和(17.81±8.56)d,差异有统计学意义(P<0.01),联合清创法的清创期时间明显短于其他2种方法的清创期时间;愈合时间分别为(107.05±100.97)d、(78.42±59.75)d和(66.21±45.39)d,差异无统计学意义﹙P>0.05);3种方法清创后第1-3周的愈合计分差异无统计学意义(P>0.05)。结论联合清创是神经内科患者压疮最适宜的清创方法,采用清创胶将坏死组织软化水解后分次剪除,可确保清创的安全有效,缩短清创期,促进伤口愈合。
Objective To explore the effect of 3 debridement methods used for pressure ulcers of patients with neurological disorders. Methods According to the inclusion and exclusion criteria,48 patients with 74 sites Ⅱ-Ⅳ grade pressure ulcers were recruited in the study. The ulcers were randomized assigned into autolytic debridement group （n=24）,conservative debridement group（n=24） and combined debridement group（n=26）. Three group wounds were assessed and debrided by consensus procedure process ,respectively. Meanwhile interventions of offloading,nutrition,activity instruction and skin care were given. When each debridement method was finished,hydrocolloid dressing was provided to the wounds for tissue growth until healed. Pressure ulcer scale of healing（PUSH）,time of debridement and healing were recorded. The score of PUSH,debridement and healing time of three groups were compared by One-way ANOVA. Results The time of autolytic,conservative and combined debridement was（34.29±17.88）d, （20.88±10.30）d and（17.81±8.56）d respectively（P〈0.001）,and the time of combined debridement was significantly shorter than the other two groups. The healing time of three groups was （107.05±100.97）d, （78.42±59.75）d and（66.21±45.39）d,the difference was no significant（P〉0.05）. The value of PUSH among three groups was also no difference（P〉0.05）. Conclusions The combination debridement method was safety and effective that can significantly shorten debridement time as well as improve wounds healing.
出处
《中华护理杂志》
CSCD
北大核心
2009年第3期197-200,共4页
Chinese Journal of Nursing
基金
南京军区南京总医院科研基金资助题
项目编号:2006032
