氧化电位水敷料在坏疽性脓皮病创面治疗的多学科团队护理的价值

The value of MDT nursing care in the treatment of pyoderma gangrenosum wounds with oxidative potential water dressings

目的:探讨氧化电位水敷料在坏疽性脓皮病(PG)创面治疗的多学科团队(MDT)护理的价值。方法:回顾性选取2020年5月至2022年8月收治的240例PG患者,按照护理或敷料的不同将患者分组:A组接受常规护理下的传统治疗,B组接受常规护理下的传统治疗+氧化电位水创面辅料治疗,C组接受MDT护理下的传统治疗,D组接受MDT护理下的氧化电位水创面辅料治疗,每组60例。比较各组患者的主要评价指标[创面相关指标(新生上皮出现时间、创面愈合率及分泌物和肉芽形态)、创面疼痛、治疗依从性]、次要评价指标(负面情绪、生活质量、舒适度、护理满意度、随访)。结果:干预后,新生上皮出现时间、分泌物积分、肉芽形态积分、数字评价量表(NRS)、汉密尔顿抑郁自评量表(HAMD)和汉密尔顿焦虑自评量表(HAMA)均呈A组>B组>C组>D组的变化趋势,创面愈合率、治疗依从性评分、生活质量评分、舒适度评分均呈A组<B组<C组<D组的变化趋势。所有患者均受17~44个月随访,A、B、C组均有个别案例发生复发或感染,均给予对症治疗。结论:氧化电位水敷料联合MDT护理干预应用于PG患者,可有效提高创面愈合率,降低创面疼痛程度,优化生活质量,消除不良情绪,增强舒适度,提高患者满意度。

Objective:To explore and compare the efficacy of oxidative potential water dressings and traditional dressings in the multidisciplinary team(MDT)nursing care and conventional nursing care on pyoderma gangrenosum(PG).Methods:240 cases of PG patients from May 2020 to August 2022 were retrospectively selected and divided into 4 groups,according to different care or dressing type:group A received traditional dressings under conventional care;group B received traditional dressings plus oxidation potential water wound excipients under conventional care;group C received traditional treatment under MDT care and group D received oxidation potential water wound excipients under MDT care.The main evaluation indicators[wound related indicators(time of neoepithelial appearance,wound healing rate,secretion and granulation morphology),wound pain,treatment compliance]and secondary evaluation indicators(negative emotions,quality of life,comfort,nursing satisfaction and follow-up)were compared.Results:After intervention,the scores of neonatal epithelium onset,secretion score,granulation morphology score,numerical rating scale(NRS),Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA)showed a change trend in group A>group B>group C>group D.The treatment compliance score,quality of life score and comfort score showed a change trend in group A<group B<group C<group D.All patients had been followed up for 17-44 months,and there were individual cases of recurrence or infection in group A,group B and group C,and symptomatic treatment was given.Conclusion:Oxidative potential water dressing combined with MDT nursing care can effectively improve wound related indicators and wound healing rate,reduce wound pain,optimize quality of life,eliminate bad emotions,enhance comfort and have high patient satisfaction.