2型糖尿病并发足部感染的伤口评估及湿性换药护理

Wound assessment and wet dressing change nursing of type 2 diabetes mellitus complicated with foot infection

目的观察伤口评估及湿性换药护理在2型糖尿病并发足部感染中的应用效果。方法选取2型糖尿病并发足部感染的患者80例,随机分为实验组和对照组各40例。2组患者均接受系统的专科治疗,包括血糖控制、医学营养治疗、改善微循环等,由专科护士评估糖尿病足伤口情况,并进行伤口初步处理。对照组应用干性护理办法,实验组则应用湿性换药护理。观察并比较2组治疗效果、截肢情况及换药次数、换药间隔时间等临床数据。结果实验组治愈29例,好转11例,总有效率100%,无截肢病例;对照组治愈21例,好转16例,总有效率为92.50%,3例截肢(7.50%)。实验组间隔(1.72±0.56)d换药,每10 d换药(4.01±0.59)次,平均(7.92±2.44)min给每个伤口换药,住院时间为(19.41±3.29)d,各指标均显著优于对照组(P<0.05)。结论对2型糖尿病并发足部感染患者进行伤口评估可了解患者情况,指导临床治疗策略,湿性换药护理可显著改善糖尿病足伤口治疗效果,延长换药间隔、减少换药次数及换药时间、缩短住院时间。

Objective To observe the effect of wound assessment and wet dressing change nursing of type 2 diabetes mellitus patients complicated with foot infection. Methods A total of 80 type 2 diabetes patients with foot infection were randomly divided into experimental group（ 40 cases）and control group（ 40 cases）. All patients accepted systematic treatment,including glycemic control,medical nutrition therapy,and micro-circulation improvement,and the diabetic foot wound condition was assessed by specialist nurses,and was initially treated. The control group applied dry nursing and the experimental group applied wet dressing change care. Therapeutic effects,amputations situation,dressing change time,and dressing change intervals were observed. Results There were29 cured cases,11 improved cases,and the total efficacy rate was 100. 00%,no amputation cases were observed in the experimental group. There were 21 cured cases,16 improved cases,3 amputated cases（ 7. 50%） in the control group,and total effective rate was 92. 50%. The intervals of dressing change was（ 1. 72 ± 0. 56） d in the experimental group,and the frequency of dressing change was（ 4. 01 ± 0. 59） times every 10 d,the average dressing change time was（ 7. 92 ± 2. 44） min for each wound,hospital stay was（ 19. 41 ± 3. 29） d,all indicators were significantly better than that in the control group（ P 〈 0. 05）. Conclusion Wound assessment for type 2 diabetes mellitus patients with foot infection can help nurses to understand the patient’s condition,and to guide clinical treatment strategies. Meanwhile,it can significantly improve treatment efficacy of wounds,prolong dressing change intervals,reduce dressing change frequencies and dressing change time,and shorten hospital stays.