伤口治疗新技术应用中的伦理学问题分析及干预研究

Analysis and intervention of ethical problems in new technique therapy of wound care

目的伤口护理中心引进负压伤口治疗新技术中遇到的伦理学问题成为隐含的风险。文中分析负压伤口治疗技术应用中存在的伦理学问题并制订和实施对策,观察效果。方法以2009年1月-2012年12月期间应用负压伤口治疗的78例患者为观察对象,观察指标为依从治疗率、治愈率和不良事件发生率。通过分析负压伤口治疗技术应用中存在的有效性和安全性及与患者经济利益冲突等伦理学问题,从伦理学"不伤害、有利、尊重和公平原则"着手制订和告知同意书及其不良事件应急处理预案,按照国际指南设计负压伤口治疗的各个环节技术,严格培训护士规范使用准入制度。结果 78例慢性伤口患者接受了负压伤口治疗,均配合完成规定治疗,依从治疗率100%,平均治愈率91.03%,无不良事件发生。治疗费用较国际标准费用节约75%,较国内费用的负压治疗费用节约66%左右。结论遵循伦理原则告知同意和良好沟通、严格准入制度和规范操作过程是新技术安全和有效使用的保障,能够确保患者利益最大化。

Objective Medical ethical problems have become underlying risks since the introduce of Negative pressure wound therapy （ NPWT） in Wound Care Center .The article was to analyze ethical problems in applying new technology in wound care and take intervention countermeasures to investigate the effects . Methods Patients treated by NPWT from January 2009 to Decem-ber 2012 were collected as objectives of investigation from the indexes of compliance rate , cure rate and adverse event rate .The ethical problems related to efficacy ,safety and conflicts of patients′economic interests during the application of NPWT were analyzed .On the basis of the ethnical core principle which was harmless , beneficial, respectful and justifiable , the details of effectiveness and safety of NPWT technique , informed consent form and emergency response protocols of the adverse events were designed according to interna -tional guidelines .Nurses received standardized training to learn new technology . Results 78 cases with chronic wounds accepted negative pressure wound therapy and all cooperated to complete treatment , compliance rate was 100%, no adverse events , the average cure rate was 91 .03%.The treatment costs are less than international and national costs from 75%to 66%. Conclusion Following the ethical principle , informed consent , good communication , strict entry system and standardized operation process make sure the safety and effectiveness of new technology and optimize patients′benefits .