摘要
目的 :总结癌性伤口的围手术期护理管理经验,提高该类疑难伤口的愈合率及治疗效率,明确伤口治疗师主导的护理管理模式在癌性伤口治疗中的重要作用。方法 :对北京医院慢性伤口门诊2019年5月至2022年5月接诊的108例癌性伤口患者,实施以伤口治疗师为主导,多学科合作为基础的综合围手术期护理管理。结果 :癌性伤口诊疗小组于2019年5月至2022年5月共接诊癌性伤口患者108例,其中98例(90.7%)患者在术后2周拆线时均实现创面的一期愈合,愈合率为90.7%。另外10例(9.3%)患者因脂肪液化、继发感染、移植后部分皮缘坏死等原因导致伤口延迟愈合,通过采取个性化的清创、伤口局部联合全身的组织活力提升策略,延迟愈合的伤口均于3~5周实现了创面的二期愈合。结论 :以伤口治疗师为核心的围手术期多学科团队合作护理管理模式,可提高癌性伤口的愈合率和治疗效率,值得进一步推广。
Objective:To summarize the experience of perioperative nursing management of Malignant Fungating Wounds,and to improve the treating effciency of such diffcult wounds,and to emphasize the importance of multidisciplinary team-based nursing management system with wound therapists as the core in the treatment of Malignant Fungating Wounds.Methods:A total of 108 patients with Malignant Fungating Wounds admitted to the Chronic Wound Clinic of one general hospital from May 2019 to May 2022 were included.The patients accepted comprehensive perioperative nursing management led by wound therapists and supported by multidisciplinary team.Results:Totally 98 patients(90.7%)achieved wound healing by primary intention when the sutures were removed 2 weeks after the operation.10 patients(9.2%)had delayed healing due to fat liquefaction,secondary infection,partial skin margin necrosis after transplantation.By adopting personalized debridement and tissue vitality promotion strategy,the delayed healing wounds all achieved healing by secondary intention in 3 to 5 weeks.Conclusion:A perioperative nursing management system with wound therapists as the lead of the multidisciplinary team can promote the healing rate and healing effciency of Malignant Fungating Wounds.It is expected that future clinical practice and study can promote the optimization of this system.
作者
罗家音
孙超
许政曦
赵红艺
傅裕
李拥军
LUO Jiayin;SUN Chao;XU Zhengxi;ZHAO Hongyi;FU Yu;LI Yongjun(Department of Vascular Surgery,Beijing Hospital,National Center of Gerontology,Beijing,100730,China)
出处
《中国护理管理》
CSCD
2022年第8期1131-1135,共5页
Chinese Nursing Management
基金
北京泰康溢彩公益基金2021年度资助课题。
关键词
癌性伤口
伤口治疗师
多学科诊疗
围手术期护理管理
Malignant Fungating Wounds
wound therapist
Multi-Disciplinary Treatment
perioperative nursing management
