中药灌洗联合改良式负压引流术对老年3、4期压力性损伤患者创面愈合影响的研究  

Effect of Chinese Medicine Lavage Combined with Modified Vacuum Sealing Drainage on Wound Healing in Senile Patients with Stage 3 and 4 Pressure Injury

作　　者：张萍 马莉亚 祝勤雅 ZHANG Ping;MA Liya;ZHU Qinya

机构地区：[1]浙江省荣军医院,浙江浙江314001

出　　处：《新中医》2022年第17期127-130,共4页New Chinese Medicine

基　　金：嘉兴市科技计划项目(2019AD32093)。

摘　　要：目的:观察中药灌洗联合改良式负压引流术对老年3、4期压力性损伤(PI)患者创面愈合的影响。方法:根据方便取样法将40例老年3、4期PI患者分为试验组与对照组各20例。2组均给予全身性支持及对症治疗,试验组采用中药灌洗联合改良负压引流术,对照组采用改良负压引流术。比较2组治疗总有效率、创面愈合时间、创面情况评分和炎症介质的表达情况。结果:试验组总有效率95.00%,高于对照组70.00%(P<0.05)。试验组创面愈合时间短于对照组(P<0.05)。与同组治疗前比较,治疗后2组创面面积评分、24 h渗出量评分、创面形态评分、压疮愈合评分表(PUSH)评分及白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)、降钙素原(PCT)、C-反应蛋白(CRP)水平均降低(P<0.05);与对照组治疗后比较,试验组治疗后创面面积评分、24 h渗出量评分、创面形态评分、PUSH评分及IL-6、TNF-α、WBC、PCT、CRP水平均较低(P<0.05)。结论:中药灌洗联合改良式负压引流术治疗老年3、4期PI患者的效果较好,可促进创面愈合,预防炎症介质爆发性释放,下调炎症反应,保护脏器功能。Objective:To observe the effect of the therapy of Chinese medicine lavage combined with modified vacuum sealing drainage on wound healing in senile patients with stage 3 and 4 pressure injury(PI).Methods:According to the convenient sampling method,40 senile patients with stage 3 and 4 PI were divided into the experiment group and the control group,with 20 cases in each group.Both groups were given systemic support and symptomatic treatment.The experiment group was treated with Chinese medicine lavage combined with modified vacuum sealing drainage,and the control group was treated with modified vacuum sealing drainage.The total effective rate,wound healing time,wound score and expression of inflammatory mediators were compared between the two groups.Results:The total effective rate was 95.00%in the experiment group,higher than that of 70.00%in the control group(P<0.05).The wound healing time in the experiment group was shorter than that in the control group(P<0.05).Compared with those in the same group before treatment,the scores of wound area,24 h exudate score,wound morphology score,pressure ulcer healing score(PUSH)and the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),white blood cell count(WBC),procalcitonin(PCT)and C-reactive protein(CRP)after treatment in both groups were decreased(P<0.05).Compared with those in the control group after treatment,the score of wound area,24 h exudate score,wound morphology score,PUSH score and the levels of IL-6,TNF-α,WBC,PCT and CRP in the experiment group were lower after treatment(P<0.05).Conclusion:The therapy of Chinese medicine lavage combined with modified vacuum sealing drainage has a good effect on elderly patients with stage 3 and 4 PI,which can promote wound healing,prevent explosive release of inflammatory mediators,reduce inflammatory responses,and protect organ function.

关 键 词：压力性损伤 老年 中药灌洗 改良式负压引流术 创面愈合 

分 类 号：R64[医药卫生—外科学]