湿性愈合理论在乳腺癌术后伤口愈合延迟患者中的应用  

Application of wet healing theory in postoperative wound healing delayed in patients with breast cancer

作　　者：刘静静[1] 陈敏[1] 朱莹莹[1] LIU Jingjing;CHEN Min;ZHU Yingying(The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233004

出　　处：《包头医学院学报》2018年第9期102-104,共3页Journal of Baotou Medical College

摘　　要：目的:探讨乳腺癌术后皮瓣坏死患者采用湿性愈合理论护理干预是否能加快坏死皮瓣的修复,以期为该类患者坏死皮瓣的处理方法提供参考。方法:选取医院2017年1月至2017年12月乳腺癌术后切口皮瓣坏死90例患者临床资料。根据患者皮瓣坏死后处理方法不同将患者分为观察组(48例)和对照组(42例),其中观察组患者坏死皮瓣给予湿性环境处理,对照组按照常规换药方法处理。分析比较两组患者皮瓣坏死2周的愈合率;采用视觉模拟评分法评估两组患者治疗前、治疗1周和治疗2周的疼痛情况;比较两组患者治疗前、治疗1周和治疗2周外周血C-反应蛋白(CRP)和白细胞/单核细胞比值;比较两组患者皮瓣愈合情况;比较两组对于治疗舒适度情况。结果:两组患者治疗前VAS评分比较差异无统计学意义(P> 0. 05),在治疗1周和2周后,观察组患者VAS评分均低于对照组,差异具有统计学意义(P <0. 05);治疗前两组患者CRP和白细胞/单核细胞比值比较差异无统计学意义(P> 0. 05),在治疗1周和2周时,观察组患者CRP和白细胞/单核细胞比值低于对照组,差异具有统计学意义(P <0. 01);治疗前两组患者皮瓣坏死面积差异无统计学意义(P> 0. 05),治疗后2周内观察组患者皮瓣坏死面积低于对照组(P <0. 01);观察组患者2周的愈合率高于对照组(P <0. 05);观察组患者治疗2周后的满意率高于对照组(P <0. 05)。结论:在乳腺癌术后皮瓣坏死的治疗中,湿性愈合理论的应用能有效地预防和治疗皮瓣坏死,且患者更易接受,可优先使用。Objective： To investigate whether nursing intervention in patients with postoperative skin flap necrosis of breast cancer can accelerate the repair of necrotic skin flap in order to provide a reference for the treatment of necrotic skin flap in patients with postoperative skin flap necrosis. Methods： The clinical data of patients with postoperative skin flap necrosis of breast cancer from January 2017 to December 2017 were selected. The patients were divided into observation group（ 48 cases） and control group（ 42 cases） according to the post-treatment of patients with skin flap necrosis,the necrotic flap in the observation group was given wet environment treatment,and the control group was treated according to the conventional dressing method. The healing rate of the two groups of skin flap necrosis for two weeks was analyzed and compared. The visual analogue scale was used to evaluate the pain of the two groups before treatment,one week after treatment and two weeks after treatment. The peripheral blood CRP,leukocyte/monocyte ratio and skin flap healing in both groups were compared before treatment,one week and 2 weeks after treatment; the two groups were compared for the treatment of comfort. Results： There was no significant difference in VAS score between the two groups before treatment（ P 〉 0. 05）. After treatment for 1 week and 2 weeks,the VAS scores of the observation group were lower than those of the control group,with significant difference（ P 〈 0. 05）. The CRP and leukocyte/monocyte ratio in the two groups before treatment had no significant difference（ P 〉 0. 05）. The CRP and leukocyte/monocyte ratio in the observation group were significantly lower than those in the control group at 1 week and 2 weeks,the difference statistically significant（ P 〈 0.01）. There was no significant difference in the necrosis area between the two groups before treatment（ P 〉 0. 05）. The necrosis area of flap in the observation group was lower than that in the control group withi

关 键 词：乳腺癌改良根治术 皮瓣坏死 湿性愈合理论 创伤愈合 并发症 

分 类 号：R473.73[医药卫生—护理学]