难愈合创面住院患者回顾性调查及相关启示  

Retrospective survey and inspiration of hospitalized patients with hard-to-heal wounds

作　　者：陈葵[1] 吴雷[1] 刘亦舒 邹吉平[1] 万雨[1] 黄英子 李秀[1] 程飚[1] 

机构地区：[1]广州军区广州总医院整形外科、创面治疗中心、全军热区损伤救治与组织修复重点实验室,510010

出　　处：《实用医学杂志》2014年第23期3849-3852,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81171812,81272105)

摘　　要：目的：回顾性调查难愈合创面住院患者的形成原因、好发部位以及住院时间等情况，为难愈合创面的防治以及研究提供资料。方法：收集2011年7月至2013年12月期间广州军区广州总医院整形外科因创面问题住院患者的病历资料。以皮肤组织缺损经2个月治疗未愈合为判定标准，筛选出难愈合创面患者120例，回顾性调查患者创面形成原因、年龄、创面发生部位、住院时间等情况。结果：我科共收治住院患者2136例，其中难愈性创面患者120例，占5．6％。创面形成的主要原因为代谢性疾病（43．3％），其次为创伤感染类（20％）和肿瘤类（20．0％）（χ2＝62．917， P ＜0．01）。创面难愈患者高发年龄段为40～60岁，其次为60～80岁（χ2＝29．562， P ＜0．01）。难愈合创面好发部位为四肢（61．6％），又以足部最为多见（占38．3％）（χ2＝17．546， P＝0．002）。目前我科全部住院患者平均住院时间为（7．41±8．98） d，慢性创面住院患者平均住院时间[（33．21±28．27） d]较同期所有住院患者明显延长（t＝－9．968， P＜0．05）。结论：代谢类疾病的中老年患者成为难愈性创面主要人群，难愈创面常发生在四肢，严重影响患者的行动，造成住院时间拖延，给患者家属、社会均带来极大负担。Objective To retrospectively investigate the causes , location and the duration of hospital stays of the hospitalized patients with hard-to-heal wounds so as to provide data guidance for the prevention and research of these diseases. Methods Clinical data of hospitalized patients with hard-to-heal wounds in plastic surgery center of General Hospital of Guangzhou Military Command were collected from June , 2011 to December, 2013. Whether ulceration was recovered in the patients with skin tissue defect after 2 months treatment was regarded as the standard to screen the patients with hard-to-heal wounds. The causes , location, age and the duration of hospital stays of the hospitalized patients with hard-to-heal wounds were investigated by retrospective case-control method. Chi-square test and t-test were used in analyzing the investigation. Results 2 136 cases, aged from 20 to 86, were treated in plastic surgery center of the hospital. 120 cases have hard-to-heal wounds, which constituted 5.62% of all hospitalized patients. （1） Metabolic disease was the main causes of wound （43.3%）, followed by wound infection and tumor （20.0% for each） （χ2 = 62.917, P 〈 0.01）. （ 2 ） The peak age for patients with hard-to-heal wounds was 40 to 60 years old patients , followed by patients′age from 60 to 80 years. （3） The mostly like hard-to-heal wounds was on limbs （61.6%）, especially on the foot （38.3%） （χ2 = 17.546, P = 0.002）. （4） The average days for hospitalization of in the plastic surgery center were （7.41 ± 8.98）, while the average days for hospitalization of the patients with years were （33.21 ± 28.27）（t = -9.968, P 〈 0.05）. Conclusion The average diagnostic age of patients with hard-to-heal wounds is the middle and old aged patients. Chronic skin ulcers, which often occurs in a limb, seriously affects a person′s ability to move , which can prolong hospital stays , causing serious burden for the families of patients and the society.

关 键 词：难愈合创面 住院 

分 类 号：R641[医药卫生—外科学]