不可分期压疮不同病理时期局部治疗方案选择分析  

Selection of Topical Treatment Protocols for Unstageable Pressure Sores at Different Pathological Stages

作　　者：唐毅 唐耘天[2] 许宇彪[3] Tang Yi;Tang Yuntian;Xu Yubiao(Department of Hepatobiliary and Pancreatic Surgery,Nanning Second People’s Hospital,Nanning City,Guangxi 530031,China;Department of Liver and Gallbladder Glands Surgery,The People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning City,Guangxi 530021,China;General Surgery Department,The Second Affiliated Hospital of Guangxi Medical University,Nanning City,Guangxi 530007,China)

机构地区：[1]南宁市第二人民医院肝胆胰外科,广西南宁530031 [2]广西壮族自治区人民医院肝胆腺体外科,广西南宁530021 [3]广西医科大学第二附属医院普外科,广西南宁530007

出　　处：《中国烧伤创疡杂志》2019年第5期312-315,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

基　　金：广西壮族自治区卫生和计划生育委员会自筹基金项目(Z20170158、Z20181035)~~

摘　　要：不可分期压疮根据其发展过程可分为坏死期、炎症反应期、肉芽生长期、上皮形成期4个病理时期。坏死期应行清创治疗,降低细菌负载和生物膜破坏;炎症反应期以控制感染和积极引流为主,如外用抗菌敷料及负压封闭引流等,以加快创面向肉芽生长期转变;肉芽生长期创面分泌物减少,宜采用烧伤创疡再生医疗技术维持创面湿性环境,以利于创面愈合及减轻疼痛;上皮形成期创面床已准备良好,采用皮肤移植、皮瓣转移等外科手术治疗可快速封闭创面,减少蛋白质损失、液体丢失、创面感染和晚期恶性并发症发生,加速创面愈合。Based on the progression course,unstageable pressure sores can be divided into four pathological sta ges:necrosis stage,inflammatory reaction stage,granulation growth stage and epithelization stage.During the necrosis stage,debridement should be performed to reduce bacterial load and the damage to biofilms;during the inflammatory reac tion stage,the management focuses should be infection control and active drainage,such as applying antibacterial dressing for external use and negative vacuum sealing drainage to accelerate the transition to the granulation growth stage.There were few wound secretions in the granulation growth stage,and MEBT/MEBO is recommended to be adopted to maintain a moist wound environment in favor of the wound healing and pain relief.In the epithelization stage,the wound bed is well prepared so that surgical operations such as skin grafting and skin flap transplantation can be performed to close the wound fast,so as to decrease the losses of protein and liquid,and avoid the occurrence of wound infection and malignant complications at the later stage,accelerating the wound healing.

关 键 词：不可分期压疮 病理时期 局部治疗 综述 

分 类 号：R47[医药卫生—护理学]