负压创面疗法在慢性难愈性创面中的应用及护理

Application and nursing of negative pressure wound therapy in the treatment of chronic refractory wounds

[目的]探讨负压创面疗法(NPWT)在治疗慢性难愈性创面中的有用性及护理措施对其应用的影响。[方法]选取2015年7月至2019年12月某医院收治的21例应用NPWT治疗的慢性难愈性创面患者临床资料,通过创面面积缩小率方式评价治疗措施及其疗效。局部治疗:清创后,对感染性创面及非感染性创面分别选择使用创面内持续负压冲洗灌流方式(IW-CONPIT)和创面持续负压吸引方式(IW-CONPT),促使创面形成良好创面床,二期重建封闭创面;护理措施:采用NPWT护理、创面常规护理、心理护理配合NPWT的实施。[结果]21例一般传统治疗3 mon仍无治愈倾向的慢性难愈性创面患者,经合理应用NPWT治疗后,其创面逐渐呈现新鲜肉芽生长,21 d创面面积缩小率为54.83%~100%(平均73.66%)。[结论]对于一般传统治疗无效的慢性难愈性创面,合理选择使用NPWT治疗,能有效控制创面感染,加快肉芽组织生长,促进创面愈合;合理有效的护理措施是保证临床疗效的关键。

[Objective]To explore the effectiveness of negative pressure wound Therapy(NPWT)for patients with chronic refractory wounds and the effect of application with nursing experience.[Methods]A total of 21 patients with chronic refractory wounds in a hospital from July 2015 to December 2019 were selected.The therapeutic effects of NPWT were evaluated by wound area reduction rate.After debridement,Local treatment of the wounds:intra-wound continuous negative pressure irrigation treatment(IW-CONPIT)and intra-wound continuous negative pressure treatment(IW-CONPT)were selected for infectious wounds and non-infectious wounds to promote the promising formation of wound-bed.The second-stage reconstruction to closure wound.Implementation of rational nursing measures(NPWT nursing,routine nursing of wound,psychological nursing).[Results]Twenty-one patients with chronic refractory wounds who had no tendency of wound healing after 3 months of general traditional treatment.After the reasonable application of NPWT treatment,the wound surface gradually showed fresh granulation growth,and the wound area reduction rate in 21 days was 54.83%~100%(average 73.66%).[Conclusion]For chronic refractory wounds that are ineffective in conventional treatments,the reasonable use of NPWT can effectively control infection of wounds,accelerate the growth of granulation tissue,and promote wound healing.Reasonable and effective nursing measures are the key to ensure the effective clinical application of NPWT.