4T原则在修复难愈性压疮中的临床应用  

Clinical application of 4T principle in the repair of refractory pressure sores

作　　者：郑梁 杨帆 徐风瑞 李江华 赵坤 吴桐 杨银辉 ZHENG Liang;YANG Fan;XU Feng-rui;LI Jiang-hua;ZHAO Kun;WU-Tong;YANG Yin-hui(Department of Burns and Plastic Surgery,Taihe Hospital of Shiyan City,Shiyan 442000,China)

机构地区：[1]十堰市太和医院(湖北医药学院附属医院)整形美容烧伤科,湖北十堰442000

出　　处：《中国美容整形外科杂志》2021年第10期610-612,616,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨4T[手术时机(timing)、修复技术(technique)、操作方法(trade-off)、康复指导(tending)]原则在修复难愈性压疮中的临床疗效。方法自2017年7月至2021年1月,十堰市太和医院整形美容烧伤科对78例难愈性压疮患者,按组织缺损程度,将压疮分型分为:Ⅰ型22例,Ⅱ型26例,Ⅲ型30例。按4T原则进行治疗,选择合适的手术时机及最优的修复方法进行治疗,并在术后进行康复指导。结果Ⅰ型患者创面均完全愈合,Ⅱ型患者有2例部分切口裂开,经清创缝合后愈合,Ⅲ型患者出现脂肪液化感染等症状8例,致切口愈合不良。所有患者均获随访6~12个月,因长时间坐立Ⅱ型患者中2例复发,Ⅲ型患者中8例复发,均经再次治疗后愈合,外观形态良好。结论针对难愈性压疮的患者,根据分型采用4T原则进行修复,方法简单安全,疗效较满意,值得临床推广应用。Objective To explore the clinical efficacy of4 T(timing, technique, trade-off, tending) principle in the repair of refractory pressure sores. Methods From July 2017 to January 2021, 78 patients with refractory pressure sores were divided into 3 types according to deep skin and tissue injury. There were 22 cases of type Ⅰ, 26 cases of type Ⅱ and 30 cases of type Ⅲ. According to 4 T principle, the appropriate timing of operation and optimal repair method were chosen for treatment. The rehabilitation guidance was given to patients after operation. Results The wounds in patients of type I healed completely. Partial incision dehiscence occurred in 2 patients of type Ⅱand healed after debridement and suture. The infection symptoms such as fat liquefaction occurred in 8 patients of type Ⅲ and the wound healing was poor. All patients were followed up for 6 to 12 months. Recurrence was found in 2 patients of type Ⅱand 8 patients of type Ⅲ because of sitting for long time. These recurrences healed after retreatment and the appearance was good. Conclusion The refractory pressure sores in patients were repaired by 4 T principle according to different types. The method was simple and safe and the curative effect was satisfactory. It should be considerable for clinical promotion and application.

关 键 词：压疮 难愈性 修复技术 4T原则 

分 类 号：R473.6[医药卫生—护理学]