摘要
目的探讨负压封闭引流联合复方四黄液持续冲洗在糖尿病足溃疡伤口护理中的应用效果。方法采用前瞻性研究方法,选取2024年9月—2025年2月中山市中医院创伤骨科病区及门诊就诊的68例糖尿病足溃疡患者为研究对象,按照随机数字表法将分为对照组(n=34)和观察组(n=34)。对照组采取便携式负压封闭引流技术联合0.9%氯化钠溶液持续冲洗,观察组采取便携式负压引流技术联合复方四黄液持续冲洗。记录患者创面面积变化情况,对比两组创面清洁时间、干预7 d后疼痛评分、创面愈合时间,干预1、2、3周后坏死组织清除率、细菌清除率,干预前后炎性指标[白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]水平变化,评价患者满意度。结果干预后两组患者创面面积较干预前缩小,且观察组创面面积较对照组更小,差异有统计学意义(P<0.01)。观察组相较于对照组的创面清洁时间、创面愈合时间明显缩短(P<0.01),干预7 d后疼痛评分相较于对照组降低(P<0.01)。两组患者干预2、3周后坏死组织清除率、细菌清除率相较于干预1周后升高,且观察组坏死组织清除率、细菌清除率更高(P<0.01)。相较于干预前,两组患者IL-8、IL-1β、IL-6水平干预后降低,且观察组炎症因子水平较对照组更低(P<0.01)。观察组患者总满意率高于对照组(P<0.05)。结论糖尿病足溃疡伤口护理中,采用便携式负压封闭引流联合复方四黄液持续冲洗可以进一步促进创面愈合,缩短康复时间,清除创面坏死组织与细菌,降低患者血清炎症因子表达水平,。
Objective To investigate the application effect of vacuum sealing drainage combined with continuous irrigation of compound Sihuang solution in the wound care of diabetic foot ulcers.Methods A prospective study was conducted.From September 2024 to February 2025,68 patients with diabetic foot ulcers admitted to the Department of Traumatology and Orthopedics of Zhongshan Traditional Chinese Medicine Hospital(Inpatient and Outpatient Departments)were enrolled.Patients were divided into a control group(n=34)and an observation group(n=34)using a random number table method.The control group received portable vacuum sealing drainage combined with continuous irrigation of 0.9%sodium chloride solution,while the observation group received portable vacuum sealing drainage combined with continuous irrigation of compound Sihuang solution.Changes in wound area were recorded.Wound cleaning time,pain score at 7 days after intervention,wound healing time,necrotic tissue clearance rate and bacterial clearance rate at 1,2,and 3 weeks after intervention,inflammatory indices[interleukin-8(IL-8),interleukin-1β(IL-1β),interleukin-6(IL-6)]before and after intervention,and patient satisfaction were compared between the two groups.Results After intervention,the wound area of both groups was smaller than that before intervention,and the wound area of the observation group was significantly smaller than that of the control group(P<0.01).The wound cleaning time and wound healing time of the observation group were sig⁃nificantly shorter than those of the control group(P<0.01),and the pain score at 7 days after in⁃tervention was lower than that of the control group(P<0.01).The necrotic tissue clearance rate and bacterial clearance rate of both groups at 2 and 3 weeks after intervention were higher than those at 1 week after intervention,and the observation group had higher necrotic tissue clearance rate and bacterial clearance rate(P<0.01).Compared with those before intervention,the levels of IL-8,IL-1βand IL-6 in both groups were decreased after intervention,and the inflammatory factor levels in the observation group were lower than those in the control group(P<0.01).The total satisfaction rate of the observation group was higher than that of the control group(P<0.05).Conclusion In the wound care of diabetic foot ulcers,the use of portable vacuum sealing drainage combined with continuous irrigation of compound Sihuang solution can further promote wound healing,shorten the recovery time,remove necrotic tissue and bacteria from the wound,and reduce the expression levels of serum inflammatory factors in patients.
作者
张玉芳
陈惠冰
ZHANG Yufang;CHEN Huibing(Department of Traumatology and Orthopedics,Zhongshan Traditional Chinese Medicine Hospital Zhongshan Traditional Chinese Medicine Hospital Affiliated with Guangzhou University of Chinese Medicine,Zhongshan,Guangdong,528400)
出处
《中西医结合护理》
2025年第9期1-6,共6页
Chinese Journal of Integrative Nursing
基金
2024年度中山市医学科研项目(20241A020205)。
关键词
糖尿病足溃疡
伤口护理
负压封闭引流
持续冲洗
复方四黄液
中医护理
炎症
diabetic foot ulcer
wound care
vacuum sealing drainage
continuous irrigation
compound Sihuang solution
Traditional Chinese Medicine nursing
inflammation
