网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
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
作者:夏玉萍  黄勇  钟俊波  张文霞 
单位:四川省自贡市第四人民医院 烧伤整形美容科, 四川 自贡 643000
关键词:氧化电位水敷料 多学科团队 坏疽性脓皮病 创面疼痛 创面愈合 护理 
分类号:R641
出版年·卷·期(页码):2024·52·第十期(1580-1586)
摘要:

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.

参考文献:

[1] MARONESE C A,PIMENTEL M A,LI M M,et al.Pyoderma gangrenosum:an updated literature review on established and emerging pharmacological treatments[J].Am J Clin Dermatol,2022,23(5):615-634.
[2] FLORA A,KOZERA E,FREW J W.Pyoderma gangrenosum:a systematic review of the molecular characteristics of disease[J].Exp Dermatol,2022,31(4):498-515.
[3] MAVERAKIS E,MARZANO A V,LE S T,et al.Pyoderma gangrenosum[J].Nat Rev Dis Primers,2020,6(1):81.
[4] 林春敏,殷如,何冬梅,等.痛阈降低护理在慢性创面不愈合患者中的应用[J].中华现代护理杂志,2022,28(4):437-441.
[5] JIANG Z,WANG Y,LI L,et al.Preparation,characterization,and biological evaluation of transparent thin carboxymethyl-chitosan/oxidized carboxymethyl cellulose films as new wound dressings[J].Macromol Biosci,2022,22(2):e2100308.
[6] 董尧文,夏颖.医护一体化多学科协作模式用于房颤患者管理的效果评价[J].现代医学,2021,49(5):565-568.
[7] BLACKWOOD O,DEB R.Multidisciplinary team approach in breast cancer care:benefits and challenges[J].Indian J Pathol Microbiol,2020,63(Supplement):S105-S112.
[8] 马益敏,王海霞,黄玉娟,等.多学科协作下的健康教育创新模式对基层医院类风湿关节炎患者健康行为的影响[J].现代医学,2022,50(5):646-650.
[9] 孙振球,徐勇勇.医学统计学[M].北京:人民卫生出版社,2020:809.
[10] GEORGE C,DEROIDE F,RUSTIN M.Pyoderma gangrenosum-a guide to diagnosis and management[J].Clin Med(Lond),2019,19(3):224-228.
[11] 张玉凤,王爱珍,周素芹,等.不同疗程奥美拉唑预防脑损伤患者应激性溃疡的临床效果分析[J].东南大学学报(医学版),2022,41(6):830-833.
[12] SNYDER R J,EAD J,GLICK B,et al.Dehydrated human amnion/chorion membrane as adjunctive therapy in the multidisciplinary treatment of pyoderma gangrenosum:a case report[J].Ostomy Wound Manage,2015,61(9):40-49.
[13] 杨帆,牟灵英,杨杨,等.不同分期坏疽性脓皮病皮肤溃疡患者的辨证施护3例[J].护理实践与研究,2023,20(20):3154-3158.
[14] TESFAYE S,SLOAN G,PETRIE J,et al.Comparison of amitriptyline supplemented with pregabalin,pregabalin supplemented with amitriptyline,and duloxetine supplemented with pregabalin for the treatment of diabetic peripheral neuropathic pain(OPTION-DM):a multicentre,double-blind,randomised crossover trial[J].Lancet,2022,400(10353):680-690.
[15] AWWAD O,ALMUHAISSEN S,AL-NASHWAN A,et al.Translation and validation of the Arabic version of the Morisky,Green and Levine(MGL) adherence scale[J].PLoS One,2022,17(10):e0275778.
[16] YIN X,LI W,LIANG T,et al.Effect of electroacupuncture on insomnia in patients with depression:a randomized clinical trial[J].JAMA Netw Open,2022,5(7):e2220563.
[17] FAN J Q,LU W J,TAN W Q,et al.Effectiveness of acupuncture for anxiety among patients with parkinson disease:a randomized clinical trial[J].JAMA Netw Open,2022,5(9):e2232133.
[18] AÇMA A,CARRAT F,HEJBLUM G.Comparing SF-36 scores collected through web-based questionnaire self-completions and telephone interviews:an ancillary study of the sentipat multicenter randomized controlled trial[J].J Med Internet Res,2022,24(3):e29009.
[19] PARSELIUNAS A,PASKAUSKAS S,SIMATONIENE V,et al.Adaptation and validation of the Carolinas Comfort Scale:a questionnaire-based cross-sectional study[J].Hernia,2022,26(3):735-744.
[20] 祁璐璐,刘锦,朱志颖,等.氧化电位水含漱对超声波牙洁治时空气中菌落数的影响[J].武警医学,2022,33(1):34-36,41.
[21] 李云云,徐帆,温春瑞,等.微酸性氧化电位水在医疗机构物体表面消毒的适用性评价[J].华西药学杂志,2021,36(4):395-400.
[22] ZHOU H Y,LIU Z H.Pyoderma gangrenosum[J].N Engl J Med,2022,387(19):e48.
[23] HONIGMAN A,KELLY R I.Pyoderma gangrenosum:a review of patient's demographics,disease and treatment in 118 patients[J].Australas J Dermatol,2022,63(2):267-269.
[24] NARLA S,SILVERBERG J I.The inpatient burden of pyoderma gangrenosum and associated comorbidities in children in the United States[J].Arch Dermatol Res,2022,314(6):613-617.
[25] 苟辉,项红梅,詹同英,等.低剂量利妥昔单抗治疗51例天疱疮患者的护理[J].中国麻风皮肤病杂志,2022,38(4):253-255.
[26] 张秋君,高湛,刘骞豪,等.多学科协作模式对宫颈癌根治术后患者自我管理效能、自我感受负担的影响[J].癌症进展,2022,20(12):1224-1227,1231.
[27] ALDHAHIR A M.Nurses' perception of,and barriers to,delivering cardiopulmonary rehabilitation for heart failure patients:a national survey in Saudi Arabia[J].Int J Environ Res Public Health,2022,19(20):13586.
[28] CHATTINNAKORN S,SUWAJO P,MEEVASSANA J,et al.The effect of cold water on pain evaluation during negative pressure wound therapy dressing changes:a prospective,randomized controlled study[J].Int J Low Extrem Wounds,2022,21(4):432-435.
[29] 张洁,费世早.多学科协作护理模式在肿瘤患者肠内营养中的应用效果[J].安徽医学,2021,42(12):1424-1427.
[30] 金铭,岑梅,赵丽静.MDT驱动下的路径式SME对CHF患者生活质量的影响[J].昆明医科大学学报,2022,43(11):185-192.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 839047 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

本系统由北京博渊星辰网络科技有限公司设计开发 技术支持电话:010-63361626

苏ICP备09058541