水胶体敷料对压疮合并中重度感染的临床疗效

Clinical effect of hydrocolloid dressings on treatment of pressure ulcer children complicated with moderate and severe infections

目的探讨水胶体敷料对Ⅲ～Ⅳ期压疮伴中重度感染患儿的临床疗效。方法选取2014年8月-2017年8月医院收治的48例Ⅲ～Ⅳ期压疮伴中重度感染患儿为研究对象,随机分为研究组与对照组,每组24例,研究组采用水胶体敷料包扎伤口,对照组采用聚维酮碘纱布覆盖伤口,比较两组患儿病原菌构成、压疮愈合计分表、创面愈合时间、治疗效果、治疗期间换药次数、局部感染症状消退时间。结果 48例压疮患者共检出病原菌95株,其中革兰阴性菌最为多见,占50.53%,前三位的病原体为大肠埃希菌、金黄色葡萄球菌、表皮葡萄球菌。两组压疮愈合计分表(pressure ulcer scale of healing,PUSH)分值均有所下降,但研究组下降程度优于对照组,临床总有效率高于对照组,且创面愈合时间、换药次数及感染症状消退时间均显著低于对照组(P<0.05)。结论红外线照射联合水胶体敷料对Ⅲ～Ⅳ期压疮伴中重度感染患儿的临床疗效优于传统治疗,可有效促进压疮愈合,控制炎症,减轻护理工作量,是一种安全有效的治疗方式,值得临床推广应用。

OBJECTIVE To explore the clinical effect of hydrocolloid dressings on treatment of stageⅢ-Ⅳ pressure ulcer children complicated with moderate and severe infections.METHODS Totally 48 children with stageⅢ-Ⅳpressure ulcer who were complicated with moderate and severe infections and treated in hospitals from Aug 2014 to Aug 2017 were recruited as the study objects and randomly divided into the study group and the control group,with 24 cases in each group.The study group was treated with hydrocolloid dressings for wound dressing,while the control group was given povidone iodine gauze to cover the wound.The species of pathogens,pressure ulcer scale of healing(PUSH),wound healing time,curative effect,frequency of dressing change during treatment and time of remission of local infection symptom were observed and compared between the two groups of patients.RESULTS A total of 95 strains of pathogens were isolated from the 48 children with pressure ulcer,50.53% of which were gram-negative bacteria;Escherichia coli,Staphylococcus aureus and Staphylococcus epidermidis ranked the top three species of pathogens.The PUSH scores of the two groups were reduced,and they were reduced more significantly in the study group than in the control group;the total effective rate of clinical treatment of the study group was higher than that of the control group;the wound healing time and time of remission of infection symptom were significantly shorter in the study group than in the control group,and the frequency of dressing change of the study group was significantly less than that of the control group(P<0.05).CONCLUSION Infrared irradiation combined with hydrocolloid dressings can achieve more remarkable clinical effect on treatment of the children with stageⅢ-Ⅳ pressure ulcer complicated with moderate and severe infections than the conventional therapy,which may effectively promote the healing of pressure ulcer,control the inflammations and alleviate the nursing workload.It is safe and effective and worthy to be promoted in the hospital.