便携式局部微氧治疗用于创伤性慢性伤口的方法及效果:一项随机对照研究

The methods and effects of portable topical oxygen therapy for traumatic chronic wounds:A randomized controlled study

目的探讨局部氧疗的适宜时机、置管方式、氧流量和疗程等方法学技巧。方法纳入2019年11月至2022年10月期间东部战区总医院收治的73例创伤性伤口患者,采用完全随机法分为试验组36例和对照组37例。试验组清创后伤口中放置微细输氧管、连接便携式局部微氧治疗仪,持续输入50%的湿化纯氧3 mL/h+标准湿性疗法每周更换3次输氧管和敷料;对照组清创后采用标准湿性疗法每周更换3次敷料。两组患者均连续干预28 d。干预前、后每周测量受试者伤口面积、深度,从面积、渗液量及组织类型3方面计分,计算2组干预期伤口面积缩小率和愈合率,判断愈合效果,计算随访12周的愈合率和愈合时间。结果试验组干预28 d的伤口面积缩小率大于对照组[(88.06±11.74)%vs(79.17±18.79)%,P=0.018],愈合率高于对照组(41.67%vs 20.0%,P=0.048),愈合计分明显低于对照组[(3.33±2.73)分vs(5.05±3.40)分,P=0.02]。随访12周时,试验组和对照组愈合率接近(100%vs 94.29%,P=0.146)。愈合时间较对照组明显缩短[(34.81±13.31)d vs(42.74±17.40)d,P=0.034]。结论便携式局部微氧治疗能够促进伤口愈合,提高治愈率和缩短愈合时间,特别适用于院外和居家伤口治疗,可为军事医学领域的伤口处置提供新思路新方法。

Objective This article aims to explore the methods of topical wound oxygen therapy(TOT)on appropriate tim⁃ing,catheter placement,oxygen flow and courses.Methods In to⁃tal,73 patients with traumatic wounds who were admitted to the hospi⁃tal from November 2019 to October 2022,were randomly divided into the intervention group with 36 cases and the control group with 37 ca⁃ses.In the intervention group,after wound debridement,tiny oxygen tubes were placed in the wound of the intervention group,and the portable continuous delivery oxygen device(CDO)was connected,50%of the humidified pure oxygen 3ml/h was continuously input,and the standard moisture wound therapy(MWT)was used to replace the oxygen tubes and dressings three times a week.In the control group,the standard MWT was used to replace the dressings three times a week after wound debridement.The two groups were continuously intervened for 28 days.Before and after the intervention,the area and depth of the wound were measured once a week,and the score was calculated from the area,exudation volume and tissue types.The wound area reduction rate and healing rate of the two groups during the intervention were also calculated in order to evaluate the healing effects.The healing rate and healing time of the following 12 weeks were calculated.Results After 28 days,in the inter⁃vention group the wound area reduction rate was higher than that of the control group(88.06%±11.74%vs 79.17%±18.79%,P=0.018),the healing rate was higher than that of the control group(41.67%vs 20.0%,P=0.048),and the healing scores were signifi⁃cantly lower than that of the control group(3.33±2.73 points vs 5.05±3.40 points,P=0.020).At 12 weeks of follow⁃up,the healing rate between the intervention group and control group was close(100%vs 94.29%,P=0.146),but the healing time of the intervention group was significantly shorter than that of the control group(34.81±13.31 days vs 42.74±17.40 days,P=0.034).Conclusion Portable TOT can promote wound healing,improve healing rate and shorten healing time.It is especially suitable for wound treatment outside the hospital and at home.It can be said that it provides new ideas and methods for wound management in the field of military medicine.