新型皮肤换药方法在维吾尔族寻常型天疱疮患者中应用效果

Effect of a new method of skin dressing change for Uygur patients with pemphigus vulgaris

目的 探讨维吾尔族寻常型天疱疮患者依沙丫啶溶液清创,磺胺嘧啶银涂抹油纱布地图式外贴的新型换药方法 在寻常型天疱疮患者皮肤换药中的应用临床效果.方法通过历史同期对照研究方法,把符合寻常型天疱疮诊断标准的维吾尔族患者分为对照组和病例组,对照组：选取2009—2012年的维吾尔族寻常型天疱疮患者,采用传统换药方法,即依沙丫啶溶液湿敷创面的换药方法.病例组：选取2013—2016年寻常型天疱疮患者,采用新型换药方法换药,即首先用依沙丫啶溶液清除创面,再用磺胺嘧啶银涂抹后油纱布进行地图式外贴.最后通过评价皮肤感染率、3周治愈率、患者对护士服务的综合满意度和护理人员皮肤换药考核的优秀率比较两种换药方法的临床疗效及护理工作质量.结果 与对照组相比,患者皮肤感染发生率由20%降至6%,3周治愈率由80%提高到98%,患者对护士服务的综合满意度由82%提高到96%,护理人员皮肤换药考核的优秀率由75.0%提高到94.4%,差异均有统计学意义（P〈0.05）.结论 新型换药方法能提高维吾尔族寻常型天疱疮患者的护理质量,减少皮肤感染发生率,提高治愈率,提高患者对护士服务的综合满意度和护理人员皮肤换药技术,促进患者康复.

Objective To investigate the clinical effect of a new method of skin dressing change for Uygur patients with pemphigus vulgaris,which is to debride by ethacridine solution,and to apply a map-style sulfadiazine silver coated oil gauze.Methods By a historical comparative method,Uygur patients diagnosed with pemphigus vulgaris were divided into control group and case group. Control group：patients with pemphigus vulgaris treated from 2009 to 2012 with traditional method of dressing change,which was to soak the wound surface with ethacridine solution. Case group：patients with pemphigus vulgaris treated from 2013 to 2016 with the new method of dressing change,which was to debride by ethacridine solution,and to apply a map-style sulfadiazine silver coated oil gauze. Finally,clinical effects and nursing work quality were compared between the two methods by evaluating skin infection rate,3-week cure rate,overall satisfaction of the patients to the nurses′ service,and excellence rate of nurses in assessment of skin dressing change.Results Compared with the control group,skin infection rate of the patients decreased from 20% to 6%,3-week cure rate increased from 80% to 98%,overall satisfaction to nursing service increased from 82% to 96%,and excellence rate of nurses in assessment of skin dressing change increased from 75.0% to 94.4% （P〈0.05）.Conclusions By applying the new method of dressing change for Uygur patients with pemphigus vulgaris,nursing quality is improved,with skin infection rate reduced,cure rate increased,overall satisfaction to the nursing service improved,nurses′ technique in dressing change improved,and rehabilitation of patients promoted.