1例Ⅱ度以上重症压疮的循证护理

Evident-based Nursing of a Patient with Grade II Decubitus and Above

目的为1例大面积压疮患者制定合理辅助治疗的循证护理方案。方法在充分评估患者病情的基础上,根据PICO原则,提出临床问题并转换成便于检索的形式,检索Cochrane图书馆(2008.1)、DARE(2008.3)、CCRT(2008.3)、MEDLINE(1980～2008.3)以及CNKI原始文献数据库。结果共检索出有关红外线照射、营养支持、特殊铺垫使用辅助治疗重度压疮的系统评价2篇、随机对照试验3篇。根据检索结果,并结合患者病情和意愿,为患者制定出有效的辅助治疗护理方案:在传统治疗的基础上,给予患者压疮部位红外线照射,15～20min/次,tid;同时口服高浓度的胶原蛋白水解产物制剂,250ml/次,tid。经过3个月的积极治疗,患者压疮已基本愈合。结论采用循证医学的方法为大面积重度压疮患者制定全面的治疗方案可促进压疮的治疗与愈合。

Objective To formulate an evidence-based adjuvant therapeutic plan for a patient with large area pressure ulcers. Methods Based on an adequate assessment of the patient＇s condition and using the principle of PICO, we searched The Cochrane Library （Issue 1, 2008）, DARE （Issue 3, 2008）, CCRT （Issue 1, 2008）, MEDLINE （1980N March 2008） and Chinese Journal Full-text Database CNKI （1979N2008） for the best available clinical evidence on adjuvant therapy of large area pressure ulcers with infrared rays, nutrition support and some special overlays. Results Two systematic reviews and three randomized controlled trials were included. According to the current evidence, as well as the patient＇s clinical condition and preference, a comprehensive therapeutic plan was given to the patient. And in the next three months with the therapeutic plan, the patient＇s large area pressure ulcers had already recovered. Conclusion Evidencebased approaches can help us develop the best comprehensive therapeutic plan for the patient and will help improve the therapeutic results for patients with large area pressure ulcers.