目的 探讨封闭负压引流技术联合贝复新治疗压力性损伤的效果。方法 选取武警辽宁总队医院2014-01至2022-10压力性损伤患者52例作为研究对象,根据入院顺序编号随机分为观察组(n=26)和对照组(n=26)。两组均在清创术中安置封闭负压引流装置后,对照组予以常规封闭负压引流治疗,观察组予以封闭负压引流技术联合贝复新治疗。观察和比较两组治疗前后疼痛评分(VAS)、压疮评分(Braden),趋化因子SDF-1α和CXCR4表达变化,术后7 d、14 d、21 d创面愈合率等。结果 与治疗前相比,两组治疗后VAS评分及Braden评分明显改善,且观察组显著优于对照组(P＜0.05);观察组治疗后趋化因子SDF-1α和CXCR4蛋白表达水平明显高于对照组(P＜0.05);两组创面愈合率随治疗时间延长而逐渐提升,观察组创面愈合率持续高于对照组(P＜0.05);观察组总有效率(92.31%)高于对照组(84.61%),有统计学差异(P＜0.05)。结论 封闭负压引流技术联合贝复新治疗压力性损伤疗效确切,能更好地促进创面愈合。
Abstract
Objective To explore the application effect of closed negative pressure drainage combined with Beifuxin in the treatment of pressure injury. Methods Fifty-two patients with stress injury who were hospitalized in Liaoning Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2014 to October 2022 were selected as the research subjects, and randomly divided into observation group (n=26) and control group (n=26) according to the admission sequence number. After the installation of closed negative pressure drainage device in debridement for both groups, the control group was treated with conventional closed negative pressure drainage, and the observation group was treated with closed negative pressure drainage combined with Beifuxin. The levels of pain score (VAS), pressure sore score (Braden), expression of chemokines SDF-1α and CXCR4, and wound healing rate at 7 d, 14 d and 21d after surgery were observed and compared between the two groups before and after the treatment. Results VAS score and Braden score in the two groups were significantly improved after treatment, and the observation group was significantly better than the control group (P<0.05).The protein expression levels of SDF-1α and CXCR4 in the observation group were significantly higher than those in the control group after treatment (P<0.05).The wound healing rate of the two groups gradually increased with the prolongation of treatment time, and the wound healing rate of the observation group was consistently higher than that of the control group (P<0.05). The total effective rate of the observation group and the control group was 92.31% and 84.61% respectively, and the therapeutic effect of the observation group was significantly better than that of the control group (P<0.05). Conclusions The technique of closed negative pressure drainage combined with Beifuxin is effective in the treatment of pressure injury, which can better promote wound healing.
关键词
压力性损伤 /
封闭负压引流 /
贝复新 /
临床疗效
Key words
stress injury /
closed negative pressure drainage /
Beifuxin /
clinical curative effect
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Headlam J,Illsley A.Pressure ulcers: an overview[J]. Brit J Hosp Med,2020,81(12):1-9.
[2] Defa A,Kazuhiro O,Tamae U,et al.Development of recurrent pressure ulcers, risk factors in older patients:a prospective observational study[J]. J Wound Care,2020,29(Sup4):14-24.
[3] 张锦锦,田 丽,王晓萍,等.压疮处理效果评价指标的循证分析[J].护理研究,2017,31(15):1828-1831.
[4] Borys S,Hohendorff J,Koblik T,et al.Negative-pressure wound therapy for management of chronic neuropathic noninfected diabetic foot ulcerations-short-term efficacy and long-term outcomes[J].Endocrine, 2018,62(3):611-616.
[5] 朱思文,张 莉,蒋邦红,等.富血小板血浆联合负压封闭引流技术治疗慢性难愈性创面的研究[J].中华全科医学,2021,19(2):205-208.
[6] 孟素玉,赵 鹏,马雅宁,等.重组牛碱性成纤维细胞生长因子治疗烧伤创面的效果观察[J].临床合理用药杂志,2020,13(26):90-92.
[7] National pressure ulcer advisory panel,European pressure ulcer advisory panel and pan pacific pressure injury alliance. Prevention and treatment of pressure ulcers:quick reference guide[R].Cambridge Media:OsbornePark,Western Australia,2014.
[8] 肖 慧,白 雪,余亦程,等.黄芪甲苷对高糖受损人内皮祖细胞分泌SDF-1α和CXCR4的影响[J].中医药导报,2020,26(12):1-4.
[9] 李 妍.封闭负压引流技术联合贝复新在压力性损伤治疗中的应用研究[D].沈阳:中国医科大学,2020.
[10] 刘 凤,赵国平,秦汉兴,等.负压封闭引流3种不同负压值对Ⅲ期、Ⅳ期压力性溃疡治疗效果的影响[J].护理研究,2018,32(1):123-124.
[11] 许 斌,贺 彦,丁 涛.不同压力值对负压封闭引流技术治疗的影响研究[J].医疗装备,2018,31(14):95-96.
[12] 刘 浩,孙 磊,齐 岩,等.封闭负压引流修复严重软组织损伤:多种因素联合应用的评价[J].中国组织工程研究,2014,18(47):7666-7671.
[13] 邱学文,龚震宇.封闭负压引流对兔压力性溃疡创面组织水肿及血流量的影响[J].广西医学,2014,36(5):599-601.
[14] 冯 光,郝岱峰,张新健,等.坐骨结节压力性损伤的分型及修复策略[J].中华损伤与修复杂志(电子版),2019,14(5):339-343.
[15] 王思佳,刘进辉,刘冬梅,等.Ⅲ级～Ⅳ级骶尾部压疮不同治疗方法效果评价对比研究[J].吉林医学,2021,42(4):835-838.
[16] Jing Z,Zhiguo L.Successful management of wound dehiscence after total knee arthroplasty by topically using recombinant basic fibroblast growth factor[J].Case Rep Clin Med,2020,09(6):154-157.
[17] Piao W,Hao Z,Yao Y,et al.Repair of facial nerve crush injury in rabbits using collagen plus basic fibroblast growth factor[J]. J Biomed Mater Res A,2020,108(6):1329-1337.
[18] 张留馨,张 茹,钟玉玲,等.压力性损伤相关性疼痛概念分析[J].中华现代护理杂志,2020,26(31):4428-4431.
[19] 蔡 浩,李文婷,练祝平,等.贝复新联合封闭式负压引流治疗外科难愈性伤口的疗效研究[J].中国医药科学,2018,8(2):202-204.
[20] 何灿粲,计晓娟,余更生,等.过表达趋化因子受体4的内皮祖细胞影响血管平滑肌细胞迁移、增殖[J].第三军医大学学报,2017,39(15):1562-1568.
[21] 陈 滔,郑 鑫,黄 杨,等.富血小板血浆通过调节SDF-1/CXCR4信号通路影响糖尿病皮瓣新生血管化机制的研究[J].中华全科医学,2016,14(6):953-956.
PDF(997 KB)
