摘要
目的:比较脊髓损伤(SCI)后并发压疮患者的2种治疗方案的临床效果及治疗费用。方法:脊髓损伤后压疮患者80例随机分为A、B 2组各40例,均采用全身治疗、压疮局部有效减压和物理治疗。同时B组采用生理盐水或3%过氧化氢溶液清洗创面,抗生素或凡士林纱条填充及纱布类敷料覆盖等传统方法;A组正确评估创面,根据压疮分期,选择适当的新型敷料综合处理,即包括坏死组织的自然清创的水凝胶、抑菌和降低水肿高渗性氯化钠的高张盐敷料、保护创面和减轻疼痛的脂质水胶敷料、填充窦道的溃疡糊和藻酸盐类敷料及利于渗液吸收的泡沫敷料覆盖等。治疗后比较2组的临床疗效、压疮愈合时间和治疗费用等。结果:经过28d的治疗,临床疗效比较,A组的治愈率及总有效率均明显高于B组(63.6%、100%与31.0%、82.8%,P<0.05,0.01);压疮愈合时间明显短于B组(P<0.05);用于压疮的日平均费用2组比较差异无统计学意义,但总费用A组低于B组(P<0.05)。结论:SCI后并发压疮患者创面配合新型敷料换药等综合处理及康复护理能缩短压疮痊愈时间,节省换药时间和开支,进而使患者整体康复质量提高,是科学、方便、经济、有效的方法。
Objective： To explore the effectiveness of two kinks of strategies for pressure ulcers following spinal cord injury.Methods： Eighty cases were randomly divided into two groups： trial group and control group（n=40 each）.Systematic treatment,effective regional decompression and physical treatment were given to both groups.In the control group,the wound surface was cleaned by saline solution or 3% peroxide solution firstly,filled with antibiotics or vaseline gauze and then covered by gauze dressings.The dressing changing frequency varied from 2 times per day to 1 time per 3 days according to the amount of exudates.In the trial group,the optional newly-developed dressings were applied according to different stages of pressure ulcers and definite assessments of the wound surface.The comprehensive treatments such as saline flushing of the wound surface,covering of bacteria static and hypertonic dressing,or lipid hydrogel dressing,or alginate padding sinus and absorbent foam dressing were given.The curative effectiveness and the ulcer healing time were compared.Results： The curative effectiveness of the trial group was better than the control group significantly and the healing time for pressure ulcer in the trial group was greatly shorter than that of the control group（P0.05）.Conclusion： The comprehensive treatments such as supportive systematic treatment,effective regional decompression and newly-developed dressings applied to the paralytic patients due to spinal cord injury combined with ulcer could not only shorten the dressing changing time and reduce expenditure greatly,but also boost holistic rehabilitation quality,the living quality and self-care ability.
出处
《中国康复》
2011年第5期387-389,共3页
Chinese Journal of Rehabilitation
关键词
脊髓损伤
压疮
综合处理
康复护理
spinal cord injury
ulcer
comprehensive treatment
rehabilitation nursing
