负压封闭结合局部氧疗用于创伤性慢性伤口的效果研究  

Effect of oxygen-enriched negative pressure-assisted wound therapy on chronic traumatic wounds

作　　者：蒋琪霞[1] 徐娟[2] 郭艳侠[1] 黄秀玲[1] 彭青[1] 李晓华[1] 

机构地区：[1]南京军区南京总医院门诊伤口护理中心,江苏南京210002 [2]南京鼓楼医院集团宿迁市人民医院骨关节科

出　　处：《护理学杂志》2016年第12期13-16,共4页Journal of Nursing Science

基　　金：南京军区医药卫生科研基金课题(14MS103);宿迁市科技局课题(S201417)

摘　　要：目的评价负压封闭结合局部氧疗用于创伤性慢性伤口除菌抑菌和改善伤口微环境的效果。方法将64例创伤性慢性伤口患者随机分为两组,每组32例。对照组给予负压封闭伤口治疗;观察组在负压封闭伤口治疗基础上24h局部给氧,持续12d。12d后两组继续按湿性疗法处理伤口或手术治疗,直至愈合或3个月止。两组干预3、6、9、12d评估测量伤口渗液pH、伤口温度,干预前和12d分泌液细菌培养监测伤口细菌阳性率;3个月内的治愈率和愈合时间。结果干预后12d观察组细菌阳性率显著低于对照组(P<0.01),两组渗液pH随治疗时间延长而下降,观察组下降更明显(P<0.01)。伤口温度随治疗时间增加而升高,观察组升高更明显(P<0.01)。观察组治愈率显著高于对照组(P<0.05),愈合时间显著短于对照组(P<0.01)。结论负压封闭结合局部氧疗治疗优化了伤口微环境,强化了除菌抑菌作用,有助于提高伤口治愈率和缩短愈合时间。Objective To evaluate the effects of oxygen-enriched negative pressure-assisted wound therapy on antibacteria and microenvironment of chronic traumatic wounds.Methods A total of 64 patients with chronic traumatic wounds were randomly divided into a control and an intervention group,each of 32.Both groups were given negative pressure-assisted wound therapy,while the intervention group was additionally provided with 24-hour topical oxygen therapy,3L/min for 12 days.Then both groups were treated with standard moist therapy or surgery until healing or for three months.The pH values of the exudates and wound temperature on day 3,6,9and 12 were measured for both groups.Before and 12 days after the intervention,the rate of positive findings of bacteria in the exudate culture was monitored and the healing rate and healing time within three months were observed between the two groups.Results The rate of positive findings of bacteria in the intervention group was significantly lower than in the control group after 12 days of intervention（P〈0.01）.The pH values of the exudates declined gradually after the intervention,and the decline was significantly more significant in the intervention group than in the control group（P〈0.01）.The wound temperature increased gradually after the treatment,with more significant increase in the intervention group than in the control group（P〈0.01）.The healing rate of the intervention group was higher than the control group,while the healing time of the former significantly shorter than the latter（P〈0.05,P〈0.01）.Conclusion Negative pressure-assisted wound therapy combined with topical oxygen therapy can optimize wound microenvironment and inhibit bacteria effectively,thus enhancing healing rate and cutting down healing time.

关 键 词：创伤性慢性伤口 负压封闭辅助闭合 负压伤口治疗 局部氧疗 微环境 

分 类 号：R473.6[医药卫生—护理学]