负压伤口治疗患者发生潮湿相关性皮肤损伤的研究

doi:10.3761/j.issn.0254-1769.2020.11.007

摘要/Abstract

摘要：

目的比较门诊患者和住院患者行负压伤口治疗期间潮湿相关性皮肤损伤的发生特征及预后,为有效护理干预提供依据。方法通过便利抽样法,选取2018年1月-2019年6月在南京市某三级甲等医院门诊行负压伤口治疗患者39例作为试验组,选取在连云港市某三级甲等医院创面修复病房行负压伤口治疗患者40例作为对照组,完成了预期的负压伤口治疗和个体化标准湿性疗法的随访治疗与观察3个月。负压治疗期间以患者潮湿相关性皮肤损伤发生率为主要结局指标,次要指标为发生时间、皮肤损伤的愈合时间、负压治疗14 d伤口面积和深度缩小率,以及随访3个月的伤口治愈率与愈合时间。结果试验组脱落1例,对照组无脱落,两组负压伤口治疗期间潮湿相关性皮肤损伤发生率分别为17.95%（7/39）和22.50%（9/40）,发生时间为（3.86±1.57） d和（3.33±1.12） d,愈合时间为（5.14±1.77） d和（5.44±1.13） d,差异无统计学意义（均P>0.05）。两组负压伤口治疗14 d伤口面积和深度缩小率、随访3个月的治愈率和愈合时间也均接近（P>0.05）。结论在门诊或住院实施负压治疗的患者均有较高的潮湿相关性皮肤损伤发生率,其发生时间及愈合时间接近。及早发现、积极干预能降低对伤口治疗近期和远期效果的影响。考虑成本和便利性,在门诊实施负压伤口治疗可能是慢性伤口治疗可探索方向。

关键词: 负压伤口疗法, 湿性疗法, 潮湿相关性皮肤损伤, 伤口愈合, 护理

Abstract:

Objective To observe and analyze characteristics of occurrence and prognosis of moisture-associated skin damage （MASD） during negative pressure wound therapy（NPWT） between outpatient and inpatient,so as to provide bases for effective interventions. Methods From January 2018 to June 2019,39 cases in the General Hospital of Eastern Theater Command were selected as experimental group,40 cases in the First People’s Hospital of Lianyungang were selected as control group by convenience sampling method. The expected NPWT treatment and individualized standard moisture therapy （MT） were conducted and patients were followed up until the wounds were healed or for 3 months. The incidence of NPWT related MASD was the primary outcome indicator. The secondary outcome indicators were the time of occurrence,the time of healing of NPWT related MASD,the wound area and depth reduction rate of 14 days after NPWT,as well as wound healing rate and healing time in 3 months follow-up. Results There was a case dropped in the exposed group and no dropped case in the non-exposed group. In 2 groups,the incidence of NPWT related MASD was 17.95%（7/39） and 22.50%（9/40）;the occurrence time was（3.86 ±1.57）d and （3.33±1.12）d;the healing time was （5.14±1.77）d and （5.44±1.13）d,respectively. The differences were not statistically significant（all P>0.05）. The reduction rates of wound area and depth in 14 days of NPWT,the healing rate and healing time of 3 months follow-up between 2 groups were also close（P>0.05）. Conclusion There was a high incidence of NPWT related MASD in the family and hospital environment,and the time of occurrence and healing time were close. Early detection and active interventions can reduce the short-term and long-term effects of wound treatment. Considering the cost and convenience,family mode NPWT may be an exploratory direction of chronic wound care in the future.

Key words: Negative-Pressure Wound Therapy, Moisture Therapy, Moisture-Associated Skin Damage, Wound Healing, Nursing Care

朱守林,蒋琪霞,李来娟,彭青,黄秀玲. 负压伤口治疗患者发生潮湿相关性皮肤损伤的研究[J]. 中华护理杂志, 2020, 55(11): 1642-1647.

ZHU Shoulin,JIANG Qixia,LI Laijuan,PENG Qing,HUANG Xiuling. Study on moisture-associated skin damage of patients with negative pressure wound therapy[J]. Chinese Journal of Nursing, 2020, 55(11): 1642-1647.

图/表 3

表1 两组一般资料的比较

Table 1 Comparison of wound characteristics between the two groups

表2 两组负压伤口治疗时间与潮湿性皮肤损伤发生特征及预后比较

Table 2 Comparison of the characteristics and prognosis of Moisture-Associated Skin Damage during the NPWT between two groups

表3 两组伤口治疗效果比较

Table 3 Comparison of wound healing effect between the two groups

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