不同类型Ⅲ~Ⅳ期压力性溃疡的个性化治疗  

Individualized treatment of different types of stage Ⅲ-Ⅳ pressure ulcers

作　　者：赵洋[1] 曾文超[1] 曲兆鹏 尤建宇 梁文勇[1] ZHAO Yang;ZENG Wenchao;QU Zhaopeng(Department of the Hand Foot and Ankle Surgery,The First People's Hospital of Jining,Jining,Shandong,272000,China)

机构地区：[1]济宁市第一人民医院手外科足踝外科,山东济宁272000

出　　处：《实用手外科杂志》2025年第1期30-33,共4页Journal of Practical Hand Surgery

基　　金：山东中医药科技项目(项目编号:2021M074)。

摘　　要：目的总结不同类型Ⅲ~Ⅳ期压力性溃疡的治疗经验。方法2016年7月-2023年1月,共收治Ⅲ~Ⅳ期压力性溃疡患者13例,外踝及足跟各1例,多部位(≥2个不同部位)3例,骶尾部3例,坐骨结节5例。按照压力性溃疡的类型,溃疡型11处,窦道型9处,混合型5处。所有患者入院后积极调整全身状态,在神经阻滞麻醉或全麻下选取扩创+负压封闭引流术、扩创+抗生素骨水泥植入+负压封闭引流术或者扩创+皮瓣修复术治疗。结果采用门诊、微信或者电话随访,所有患者均愈合。随访0.5~1年,未发生新的Ⅲ~Ⅳ期压力性溃疡。结论Ⅲ~Ⅳ期压力性溃疡的治疗需要从全身及局部两个方面入手。按照患者的全身状态及压力性溃疡的类型选择合适的个性化治疗方案,效果满意。Objective To summarize the treatment experience of different types of stage Ⅲ-Ⅳ pressure ulcers.Methods From July 2016 to January 2023,13 patients with stage Ⅲ-Ⅳ pressure ulcer were admitted to our hospital,Pressure ulcer occurred in lateral malleolus and heel in 1 case,multiple sites(≥2 different sites)in 3 cases,sacrococcygeal region in 3 cases,and ischial tuberosity in 5 cases.According to the type of pressure ulcer,11 cases were ulcerative type,9 cases were sinus tract type,and 5 cases were mixed type.After admission,all patients actively adjusted their general state,and selected debridement+vacuum sealing drainage,debridement+antibiotic bone cement implantation+vacuum sealing drainage,or debridement+flap repair under nerve and nerve plexus tissue anesthesia or general anesthesia.Results All patients were followed up by outpatient,wechat or telephone.No new stage Ⅲ-Ⅳ pressure ulcers occurred during the follow-up period.Conclusion The treatment of stage Ⅲ-Ⅳ pressure ulcer should be based on systemic and local aspects.According to the type of pressure ulcer,the appropriate individualized treatment plan is selected,and the effect is satisfactory.

关 键 词：压力性溃疡 个性化治疗 皮瓣 负压 骨水泥 

分 类 号：R47[医药卫生—护理学]