湿性敷料在体表慢性难愈合伤口中的应用  

Application Effect of Moist Dressings in Chronic Refractory Wounds on Body Surface

作　　者：雷莉华[1] 李小芳[1] 邓琨 雷霞[1] LEI Li-hua;LI Xiao-fang;DENG Kun;LEI Xia(Department of Stoma Difficult Wound,the First People's Hospital of Chenzhou,Chenzhou 423000,Hunan,China)

机构地区：[1]郴州市第一人民医院造口疑难伤口科,湖南郴州423000

出　　处：《中国美容医学》2021年第10期36-40,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨湿性敷料在体表慢性难愈合伤口中的应用效果。方法:选取2018年7月-2020年7月笔者医院体表慢性难愈合伤口患者489例,随机数字表法分为观察组(n=245)与对照组(n=244),对照组给予凡士林纱布干性疗法覆盖创面,观察组给予湿性敷料覆盖创面,比较两组创面愈合率、创面渗液情况、创面色泽及肉芽组织和上皮生长情况、创面疼痛程度、色素沉着及瘢痕情况。结果:观察组治疗后9周痊愈率58.37%高于对照组的48.77%,总有效率95.10%高于对照组的90.16%,差异有统计学意义(P<0.05)。观察组治疗后1周、3周、5周、7周、9周创面愈合率均高于对照组,差异有统计学意义(P<0.05)。观察组治疗后1周、3周、5周、7周、9周创面渗液量评分低于对照组,差异有统计学意义(P<0.05)。观察组治疗后3周、5周、7周创面肉芽组织与上皮生长评分低于对照组,差异有统计学意义(P<0.05)。观察组治疗后1周、3周、5周疼痛评分低于对照组,差异有统计学意义(P<0.05)。观察组治疗后3个月瘢痕增生与色素沉着发生率分别为28.98%、52.24%低于对照组39.34%、65.16%,差异有统计学意义(P<0.05)。结论:湿性敷料相较于干性敷料可加速体表慢性难愈合伤口的愈合,减少创面渗出,改善创面肉芽组织与上皮生长情况,减轻患者疼痛感,减少色素沉着与瘢痕增生。Objective To explore the application effect of moist dressings in chronic refractory wounds on body surface.Methods A total of 489 patients with chronic refractory wounds on body surface who were admitted to the hospital from July 2018 to July 2020 were enrolled.They were divided into the observation group(n=245)and the control group(n=244)by random number table method.The control group was given vaseline gauze dry therapy to cover the wounds,while the observation group was given moist dressings to cover wounds.The wound healing rate,wound exudation,wound color,granulation tissue and epithelial growth,wound pain,pigmentation and scars were compared between the two groups.Results After 9 weeks of treatment,the cure rate of the observation group was 58.37%,higher than that of the control group(48.77%),and the total effective rate was 95.10%higher than that of the control group(90.16%),the differences were statistically significant(P<0.05).The wound healing rates of the observation group at 1 week,3 weeks,5 weeks,7 weeks and 9 weeks after treatment were higher than those of the control group(P<0.05).The scores of wound exudation in the observation group at 1 week,3 weeks,5 weeks,7 weeks and 9 weeks after treatment were lower than those in the control group(P<0.05).The scores of granulation tissue and epithelial growth in the observation group were lower than those in the control group at 3,5 and 7 weeks after treatment(P<0.05).The pain scores of the observation group were lower than those of the control group at 1,3 and 5 weeks after treatment(P<0.05).The incidence of scar hyperplasia and pigmentation in the observation group were 28.98%and 52.24%respectively,which were lower than those in the control group(39.34%and 65.16%,P<0.05).Conclusion Compared with dry dressings,moist dressings can accelerate the healing of chronic refractory wounds on body surface,reduce wound exudation,improve wound granulation and epithelial growth,alleviate pain,reduce pigmentation and scar hyperplasia.

关 键 词：慢性难愈合伤口 体表 湿性敷料 创面愈合 瘢痕增生 

分 类 号：R622[医药卫生—整形外科]