摘要
目的:探讨龙血竭-栀子与氦氖激光联合局部治疗肠造口皮肤黏膜分离的临床疗效。方法:选取2024年1月至2025年1月赣州市3所三甲医院收治的因造口血运不良导致肠造口皮肤黏膜分离患者60例。按随机数字表法分为对照组和试验组,每组30例。对照组接受常规护理+银离子藻酸盐敷料填充治疗;试验组在常规护理基础上,外用龙血竭粉与栀子粉按1∶1比例混合均匀,用生理盐水调成糊剂,外敷后行氦氖激光照射20~30 min,清除糊剂后再以龙血竭与栀子按1∶1比例混合粉末外撒创面,并以藻酸盐敷料填充。比较2组患者治疗效果、创面局部情况及并发症发生率。结果:试验组患者在创面疼痛缓解时间、异味消除时间、创面色泽红润时间、新生肉芽组织覆盖创面面积≥75%时间及分离伤口愈合时间均短于对照组,差异有统计学意义(P<0.001)。治疗7 d后,试验组患者伤口床渗液、伤口边缘失活组织、伤口周围皮肤浸渍及湿疹程度均低于对照组,差异有统计学意义(P<0.05)。术后3个月随访显示,试验组患者造口回缩、狭窄及皮肤瘢痕发生率均低于对照组(P<0.05)。结论:龙血竭-栀子联合氦氖激光及藻酸盐敷料联合应用治疗造口皮肤黏膜分离优于银离子藻酸盐敷料方案。该综合疗法具有活血散瘀、解热止痛、去腐生肌及抑菌抗炎作用,能快速促进创面愈合、改善局部微循环、维持湿性愈合环境,并可有效降低并发症发生率,具备良好的临床应用价值,值得推广。
Objective:To investigate the clinical efficacy of the combined topical application of Draconis Sanguis-Gardenia and helium-neon laser in the treatment of enterostomy skin-mucosal separation.Methods:A total of 60 patients with enterostomy skin mucosal separation caused by stomal ischemia from three Grade A tertiary hospitals in Ganzhou City were enrolled between January 2024 and January 2025.They were divided into a control group and an experimental group using a random number table,with 30 patients in each group.The control group received routine care plus silver alginate dressing packing.The experimental group received routine care in addition to a topical treatment comprising a paste made from a 1∶1 mixture of Draconis Sanguis powder and Gardenia powder blended with normal saline.After topical application,the area was irradiated with a helium-neon laser for 20-30 min.The paste was then removed,and the wound was dusted with a 1∶1 mixture of Draconis Sanguis and Gardenia powder,followed by alginate dressing packing.Treatment efficacy,local wound condition,and complication rates were compared between the two groups.Results:In the experimental group,the time for wound pain relief,the time for odor elimination,the time for the wound to turn red and moist,the time for newly formed granulation tissue to cover≥75%of the wound area,and the time for separated wound healing were all shorter than those in the control group,with statistically significant differences(P<0.001).After 7 days of treatment,the levels of wound bed exudate,necrotic tissue at the wound edge,skin maceration around the wound,and eczema in the experimental group were all lower than those in the control group,and the differences were statistically significant(P<0.05).A 3-month post-operative follow-up showed that the incidence of complications such as stoma retraction,stenosis,and skin scarring in the experimental group was lower than that in the control group(P<0.05).Conclusion:The combined application of sanguis draxonis,gardenia,helium-neon laser and alginate dressing in the treatment of skin mucosal separation of ostomy is superior to the silver ion alginate dressing.The combined application can activate blood circulation,remove blood stasis,reduce fever and relieve,remove decay and promote granulation,inhibit bacteria and prevent infection,and promote the immune system to clear infection and the healthy growth of granulation,without stimulation,toxic and side and secondary infection,improve the microcirculation of the wound,strengthen the metabolism,form a humid environment,and promote healing,reduce complications,which has a good clinical application value and is worth promoting.
作者
吴有秀
冯琍平
林青霞
伍海燕
邓伟
陈燕
肖梦婷
何桂珍
叶新英
WU You-xiu;FENG Li-ping;LIN Qing-xia;WU Hai-yan;DENG Wei;CHEN Yan;XIAO Meng-ting;HE Gui-zhen;YE Xin-ying(Yudu Center for Disease Control and Prevention;The First Affiliated Hospital of Gannan Medical University;Gannan Medical University,Ganzhou,Jiangxi 341000)
出处
《赣南医科大学学报》
2025年第11期1076-1081,共6页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
基金
江西省卫生健康委员会资助项目(202410053)。
关键词
龙血竭-栀子
氦氖激光
造口皮肤黏膜分离
治疗效果
Sanguis draxonis
Gardenia
Helium-neon laser
Stoma skin and mucosa separation
Therapeutic effect
