给氧负压封闭伤口治疗在骨科慢性伤口中的应用效果研究  

A study on the effects of negative pressure wound therapy combined with topical oxygen therapy on orthopedic chronic wounds

作　　者：徐娟[1] 蒋琪霞[2] 刘颖[1] 陈星[1] 

机构地区：[1]南京鼓楼医院集团宿迁市人民医院骨关节科,江苏省宿迁市223800 [2]南京军区南京总医院门诊伤口护理中心

出　　处：《中华护理杂志》2016年第6期650-654,共5页Chinese Journal of Nursing

基　　金：南京军区科技创新课题(14MS103);宿迁市科技局课题(S201417)

摘　　要：目的探讨负压伤口疗法联合局部给氧治疗骨科慢性伤口的抑菌促愈效果。方法将60例患者随机分为试验组和对照组,每组30例。试验组在负压伤口治疗的基础上局部给氧2L/min,连续10d。对照组给予负压伤口治疗,连续10d。之后,两组均给予手术治疗或标准湿性疗法至愈合并随访3个月。结果干预后第10天,试验组细菌培养阳性率低于对照组(P<0.05),伤口渗液p H低于对照组(P<0.01),伤口温度高于对照组(P<0.01),肉芽组织覆盖率高于对照组(P<0.01),两组压疮愈合计分量表计分结果差异无统计学意义(P>0.05)。随访期内试验组治愈率高于对照组(P<0.01),平均愈合时间短于对照组(P<0.05)。结论给氧负压封闭伤口治疗有利于控制骨科慢性伤口感染,促进肉芽组织生长,提高伤口治愈率并缩短伤口愈合时间,效果优于单纯负压伤口疗法。Objective To explore the antibacterial and healing effects of negative pressure wound therapy （NPWT） combined with topical oxygen therapy （TOT） on orthopedic chronic wounds. Methods Totally 60 patients with orthopedic chronic wounds were recruited and divided into two groups randomly with 30 patients in each group. The control group was treated by NPWT for 10 days,and the intervention group was treated by NPWT and TOT with 2IJmin for 10 days. Ten days later,all patients were treated by surgery or standard moist therapy until healing or followed up for 3 months. Indicators：pH of wound fluid,wound temperature,pressure ulcer scale for healing （PUSH） scores,coverage rate of granulation tissue and positive rate of bacteria of wound at day 0 and day 10,and healing rate and healing time. Results After 10 days of intervention,the positive rate of bacteria in the intervention group was lower than that in the control group（13.33% v.s. 46.67%,P〈0.05）. The pH of wound fluid in the intervention group was lower than that in the control group（P〈0.01）.The wound bed temperature in the intervention group was higher than that in the control group（P〈0.01）.The coverage rate of granulation tissue in the intervention group was higher than that in the control group（P〈0.01）.The PUSH scores between two groups had no significant difference（P〉0.05）.The healing rate of the intervention group was higher than that of the control group（86.67% v.s. 53.33%,P〈0.01） during follow-up.The healing time in the intervention group was shorter than that in the control group （P〈0.05）. Conclusion NPWT combined with TOT was beneficial to infection control,the growth of granulation tissue, and improvement of healing rate and healing time. NPWT combined with TOT were superior to NPWT alone.

关 键 词：外科伤口感染 负压伤口疗法 

分 类 号：R473.6[医药卫生—护理学]