红光、蓝光光子治疗对四肢毁损伤皮瓣修复术后创面愈合的效果观察  

Effect of red-blue light photon assisted therapy on wound healing after flap reconstruction of traumatic defects of extremities

作　　者：黄新艳 钱会娟 何丹[1] 鲍丙波 郑宪友[2] 胡三莲 Huang Xinyan;Qian Huijuan;He Dan;Bao Bingbo;Zheng Xianyou;Hu Sanlian(Nursing Department,the Sixth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China;Orthopaedics Department,the Sixth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院护理部,上海200233 [2]上海交通大学医学院附属第六人民医院骨科,上海200233

出　　处：《现代临床护理》2024年第9期45-49,共5页Modern Clinical Nursing

基　　金：上海市护理学会面上项目,项目编号为2019MS-B09;上海交通大学医学院护理学科建设项目,项目编号为SJTUHLXK2021。

摘　　要：目的探讨红光、蓝光光子治疗对四肢毁损伤皮瓣修复术后创面愈合的效果。方法采用便利抽样法,选取2020年1月至2021年12月在上海市某三级甲等综合医院显微病房住院行四肢软组织缺损皮瓣修复术后146例患者作为研究对象,其中2020年1月—12月的70例患者为对照组,2021年1月—12月的76例患者试验组。对照组患者采用60W烤灯对皮瓣局部加温,24h持续照射,维持1~2W,灯距约为30~45cm。试验组患者在对照组的基础上增加红光、蓝光光子治疗,每日2次,每次蓝光照射20min,红光照射20min,灯距为8~12cm。比较两组患者术后1d、3d、5d、7d创面组织张力、术后7d感染发生率及术后2w皮瓣存活率。结果两组患者皮瓣组织张力变化的差异在术后第1d和第3d无统计学意义(均P>0.05),在术后第5d、第7d具有统计学意义(均P<0.001)。试验组术后7d感染发生率低于对照组,差异有统计学意义(P<0.05)。试验组术后2w皮瓣成活率高于对照组,差异具有统计学意义(P<0.05)。结论红、蓝光光子对四肢毁损伤皮瓣修复术后创面进行治疗,可有效改善皮瓣术后创面组织张力,降低感染发生率,提高皮瓣成活率。Objective To evaluate the effect of red-blue light photon assisted therapy on wound healing after flap reconstruction of limb traumatic defects.Methods A total of 146 patients who were admitted to the Ward of Microsurgery of ⅢA hospital of Shanghai from January 2020 to December 2021 and received flap reconstruction surgery for soft tissue defects of limbs were included in this prospective observational study.According to the order of admission,patients were divided into a control group(n=70)and an trial group(n=76).In the control group,a 60W thermal lamp was offered to the patients for locally heating the flaps,with continuous irradiation for 24 hours with a maintaining power of 1-2W,at an approximately 30-45 cm in distance from the flap.In the trial group,based on the thermal irradiation applied to the control group,a combined red and blue light photon irradiation therapy was offered as an additional measure,by twice a day at 20 minutes per session of blue-red light photon irradiation,at 8-12cm in distance from the flap.The two groups were compared in terms of tension of tissues around flap,incidence of infection within 7 days after surgery and the survival of flap within 2 weeks after surgery.Results The two groups showed no significant difference in terms of tissue tension between the 1st and 3rd day after surgery(P<0.05),but with significant differences on the 5th and 7th day after surgery(P>0.05).The trial group exhibited significantly lower incidence of infection within 7 days after surgery compared to that of the control group(P<0.05),and with a significantly higher flap survival rate at 2 weeks after surgery(P<0.05).Conclusion After the flap reconstruction of soft tissue defects of limbs,a red-blue light assisted photon irradiation therapy can effectively improve postoperative tissue tension around a flap,reduce infection rate and improve the survival rate of a flap.It provides an effective and safe interventional measures for postoperative care of the transferred flap.

关 键 词：红光光子治疗 蓝光光子治疗 肢体毁损伤 皮瓣 创面 护理 

分 类 号：R473.6[医药卫生—护理学]