摘要
目的探讨三种清创方法结合整体护理干预治疗Ⅱ～Ⅳ期压疮的效果。方法将48例(74处)Ⅱ～Ⅳ期压疮患者随机分为三组,分别采取自溶清创、保守性锐器清创和自溶联合保守性锐器清创,同时给予减压、营养、活动指导、皮肤护理等整体护理干预。结果总治愈率为94.59%,愈合时间为(83.23±72.59)d。三组治愈率比较,差异无统计学意义(P>0.05);三组愈合时间比较,差异有统计学意义(P<0.01)。结论三种清创方法均能有效清创,结合全程整体护理干预能提高压疮愈合率和缩短愈合时间,其中以自溶联合保守性锐器清创效果最好。临床应用中应结合患者的自身情况进行综合分析,采取针对性护理干预措施,以提高压疮的治疗效果。
Objective To compare the effects of three debridement methods in combination with holistic care on staging Ⅱ,Ⅲ or Ⅳ pressure ulcers.Methods A total of 48 cases （74 pressure ulcers at stage of Ⅱ,Ⅲ or Ⅳ） were randomized into three groups：group 1 were subjected to autolysis debridement,group 2 to conservative wound debridement with sharps,and group 3 to autolysis and conservative wound debridement with sharps,respectively.Meanwhile,holistic nursing interventions including surface decompression,nutrition supply,activity guidance and skin care were provided to every case.Results The healing rate of 74 pressure ulcers was 94.59% and mean healing time were （83.23±72.59）d.The differences in healing rate among the three groups were not significant（P〉0.05）,but the healing time among three groups were significantly different（P〈0.01）.Conclusion Three debridement methods are effective and able to enhance the healing rate and cut down healing days if combined with holistic nursing interventions.The effect of autolysis and conservative wound debridement with sharps is the best.In order to improve the treatment effect of pressure ulcers,patients′ conditions should be carefully considered and individualized interventions should be targeted to them.
基金
南京军区南京总医院科研基金资助课题(2008001)
关键词
压疮
自溶清创
保守性锐器清创
自溶联合保守性锐器清创
湿性疗法
伤口护理
pressure ulcers
autolysis debridement
conservative wound debridement with sharps
autolysis and conservative wound debridement with sharps
moist wound healing
wound care
