持续微氧渗透联合改良双负压疗法治疗Ⅲ~Ⅳ期压力性损伤的临床研究

Clinical Study of Continuous Micro-oxygen Osmosis Combined with Modified Double Negative Pressure Therapy in the Treatment of StageⅢ-ⅣPressure Injury

目的观察持续微氧渗透联合改良双负压疗法治疗Ⅲ~Ⅳ期压力性损伤的临床疗效。方法选取2017年6月—2020年6月在该院诊治的60例Ⅲ~Ⅳ期压力性损伤患者,随机数表法分为观察组和对照组,各30例。对照组给予改良双负压吸引,观察组在对照组基础上联合持续微氧渗透,持续治疗28 d。观察伤口面积缩小率、肉芽组织覆盖率、创面细菌培养阳性率,应用压力性损伤愈合计分表(PUSH)评估伤口愈合情况,记录90 d愈合率和愈合时间,评价临床疗效。结果观察组伤口面积缩小率和肉芽组织覆盖率均明显高于对照组,差异有统计学意义(t=10.934、12.501,P<0.05);观察组创面细菌阳性率明显低于对照组,差异有统计学意义(t=-49.572,P<0.05);观察组90 d愈合率为(96.21±2.88)%,愈合时间为(105.17±4.45)d,优于对照组的(78.43±3.37)%,(119.50±6.35)d,差异有统计学意义(t=21.969、-10.125,P<0.05)。两组患者治疗前PUSH评分差异无统计学意义(t=-0.444,P=0.659),治疗后两组患者PUSH评分均明显降低,且观察组下降更为明显,差异有统计学意义(t=-9.560,P<0.05);观察组临床总有效率为93.30%明显高于对照组的66.60%,差异有统计学意义(χ^(2)=6.667,P<0.05)。结论持续微氧渗透联合改良双负压疗法加速Ⅲ~Ⅳ期压力性损伤患者的创面愈合,提高治愈率。

Objective To observe the clinical effect of continuous micro-oxygen osmosis combined with modified double negative pressure therapy in the treatment of stageⅢ-Ⅳpressure injury.Methods A total of 60 patients with stageⅢtoⅣpressure injury who were diagnosed and treated in the hospital from June 2017 to June 2020 were selected and random number rariation divided into an observation group and a control group,with 30 cases in each group.The control group was given modified double negative pressure suction.On the basis of the control group,the observation group was combined with continuous micro-oxygen osmosis and continued to treat for 28 d.The wound area reduction rate,granulation tissue coverage rate,and the positive rate of bacterial culture on the wound surface were observed,and the pressure injury healing score(PUSH)was used to evaluate the wound healing.The 90 d healing rate and healing time were recorded,and the clinical effect was evaluated.Results The wound area reduction rate and granulation tissue coverage rate in the observation group were significantly higher than those in the control group,and the difference was statistically significant(t=10.934,12.501,P<0.05).The positive rate of bacteria on the wound surface of the observation group was significantly lower than that of the control group,and the difference was statistically significant(t=-49.572,P<0.05).The 90 d healing rate of the observation group was(96.21±2.88)%,and the healing time was(105.17±4.45)d,better than(78.43±3.37)%,(119.50±6.35)d in the control group,the difference was statistically significant(t=21.969,-10.125,P<0.05).There was no statistically significant difference in the PUSH scores between the two groups before treatment(t=-0.444,P=0.659),and the PUSH scores of the two groups were significantly decreased after treatment,and the decrease in the observation group was more obvious,and the difference was statistically significant(t=-9.560,P<0.05).The total clinical effective rate of the observation group was 93.30%,which was significantly higher than that of the control group,which was 66.60%,and the difference was statistically significant(χ^(2)=6.667,P<0.05).Conclusion Continuous micro-oxygen osmosis combined with modified double negative pressure therapy could accelerate wound healing in patients with stageⅢ-Ⅳpressure injury and improve the cure rate.