摘要
目的 :分析负压伤口治疗结合局部氧疗用于慢性伤口的抑菌效果和愈合效果以及抑菌率与伤口愈合之间的关系。方法 :纳入96例慢性伤口患者,随机分为干预组和对照组,每组48例。干预组清创后实施负压伤口治疗结合局部氧疗14天,对照组清创后实施负压伤口治疗14天,之后两组均采用标准湿性治疗每周3次,随访至愈合或随访5个月。效果指标为干预前和干预后14天两组细菌培养阳性率、抑菌率,随访期内两组伤口的愈合率和愈合时间。结果 :干预组干预14天的细菌培养阳性率明显低于对照组(14.58%vs54.17%,P<0.05),干预组对单种和2种细菌共存的抑菌率均明显高于对照组(73.08%vs11.11%,100.00%vs66.67%,均P<0.05)。随访5个月内干预组伤口愈合率高于对照组(100.00%vs89.13%,P<0.05),愈合时间缩短了20.84天(P<0.05)。Pearson相关性分析结果显示,干预组的抑菌率与伤口愈合之间存在正相关关系(r=0.480,P<0.05),对照组抑菌率与伤口愈合之间不存在相关关系(r=0.083,P>0.05)。结论:负压伤口治疗结合局部氧疗增强了抑菌作用,优化了伤口愈合效果,抑菌作用对慢性伤口愈合有促进作用,可为慢性伤口护理和管理提供新思路和新方法。
Objective:To analyze the bacteriostasis and healing effects of Negative Pressure Wound Therapy(NPWT)combined with Topical Oxygen Therapy(TOT)for chronic wounds,and the relationship between them.Methods:Totally 96 patients with chronic wounds were randomly divided into the intervention group and the control group,with 48 patients in each one.The intervention group was treated NPWT combined with TOT for 14 days after debridement,while the control group was treated with NPWT for 14 days after debridement,after that followed by standard Moist Wound Therapy 3 times a week,and followed up to healing or 5 months.Efficacy indicators:the change of bacterial positive rate and bacteriostatic rate of the two groups before and 14 days after the intervention,and the wound healing rate and healing time of the two groups during the follow-up period.Results:The bacterial positive rate of the intervention group on the 14th day of intervention was significantly lower than that of the control group(14.58%vs 54.17%,P<0.05),and the bacteriostatic rate of the intervention group on the coexistence of single and two bacteria were significantly higher than that of the control group(73.08%vs 11.11%,100.00%vs 66.67%,all P<0.05).The wound healing rate in the intervention group was higher than that in the control group(100.00%vs 89.13%,P<0.05),healing time shortened by 20.84 days(P<0.05).Pearson correlation analysis showed that there was a positive correlation between the bacteriostasis rate and wound healing in the intervention group(r=0.480,P<0.05),while there was no correlation between the bacteriostasis rate and wound healing in the control group(r=0.083,P>0.05).Conclusion:NPWT combined with TOT can enhance the bacteriostasis and optimize the healing effects.The bacteriostasis can promote the healing of chronic wounds,and can provide new ideas and methods for the nursing and management of chronic wounds.
作者
蒋琪霞
朱玉玲
刘国帧
吴芸
范丽华
彭青
刁品君
白育瑄
JIANG Qixia;ZHU Yuling;LIU Guozhen;WU Yun;FAN Lihua;PENG Qing;DIAO Pinjun;BAI Yuxuan(Department of Burns and Plastic Surgery,General Hospital Eastern Theater Command of PLA,Nanjing,210002,China)
出处
《中国护理管理》
CSCD
2023年第4期491-496,共6页
Chinese Nursing Management
基金
全军卫勤创新课题(20WQ027)
上海王正国创伤医学发展基金会课题(WZGF20200101)。
关键词
负压伤口治疗
局部氧疗
慢性伤口
伤口愈合
Negative Pressure Wound Therapy
Topical Oxygen Therapy
chronic wound
wound healing
