两种不同方法处理坏死黑痂创面的疗效观察  

Curative effects of two therapies for wounds of necrotic dark crust

作　　者：董兰菊 成守珍[2] 宋杰丽 王维平[2] 王淮玲[2] 朱燕妮 

机构地区：[1]从化市中心医院,广东从化510900 [2]中山大学附属第一医院,广东广州510080

出　　处：《现代临床护理》2012年第11期28-30,共3页Modern Clinical Nursing

摘　　要：目的探讨两种不同方法处理坏死黑痂创面的疗效。方法选择2010年5月～2011年6月23例(创面25处)坏死黑痂创面患者作为对照组,2011年7月～2012年7月19例(创面24处)坏死黑痂创面患者作为实验组,两组均在基础疾病及抗感染治疗同时,对照组患者创面给予一次性清创加改良封闭式负压引流治疗,实验组患者创面给予直接或黑痂深层切开加改良封闭式负压引流治疗,并适时逐次清创,肉芽组织生长好部位点状植皮。比较两组患者创面完成清创时间、清创出血量及8周治疗效果。结果两组患者创面完成清创时间、清创出血量及8周治疗效果比较,均P﹤0.05,差异具有统计学意义,实验组患者完成清创时间明显短于对照组,清创出血量明显少于对照组、8周治愈率明显高于对照组。结论坏死黑痂创面采用直接或黑痂深层切开后加改良封闭式负压引流治疗,并适时逐次清创,肉芽组织生长好部位给予点状植皮治疗效果优于一次性清创加改良封闭式负压引流治疗。Objective To explore the curative effects of two different therapies in treating the wounds of necrotic dark crust. Methods 25 wounds in 23 patients with ecrotic dark crust from May 2010 to June 2011 were assigned as the control group and the 24 wounds in another 19 patients with necrotic dark erust from July 2011 to June 2012 as the experiment group. Both groups were basically treated with anti-infection treatments. Besides, the control group received disposable debridement and modified VAC treatments after their diseases were stable, while the experiment group received modified VAC directly on the wounds or after the dark crust was deeply open, followed with successive debridement and punctuate skin grafting where the granulation tissue had grown well. The two groups were compared in respect of completion time of debridement, the blood loss in debridement and the curative effect in 8 weeks. Result Compared to the control group, the completion time of debridement in the experimental group was significantly earlier, the blood loss in debridement was significantly less and the curative effect in 8 weeks was significantly superior （P 〈 0.05, for all）. Conclusion The modified VAC used directly on the wounds or after the dark crust was deeply open, followed with successive debridement and punctiform skin grafting where the granulation tissue had grown well, is superior to disposable debridement with modified VAC treatments.

关 键 词：坏死黑痂 改良封闭式负压引流 清创 

分 类 号：R472[医药卫生—护理学]