象皮生肌膏治疗Ⅲ~Ⅳ度压疮临床应用.docVIP

象皮生肌膏治疗Ⅲ~Ⅳ度压疮临床应用[摘要] 目的:探讨象皮生肌膏对治疗Ⅲ、Ⅳ度压疮的临床效果,为临床提供一种新的治疗压疮的方法。方法:开始我们采取传统创面换药方法,效果不明显,后改用定时翻身、全身综合护理、心理护理和康复训练加象皮生肌膏换药的方法治疗。结果:5周后Ⅲ期压疮创面愈合,6周后Ⅳ压疮也基本愈合。结论:象皮生肌膏对治疗Ⅲ、Ⅳ压疮有较好的治疗效果,值得临床推广使用。 [关键词] 压疮;象皮生肌膏;临床应用 [中图分类号] R473.5[文献标识码]C [文章编号]1673-7210(2010)03(b)-077-02 Clinical application of rubber myogenic cream in Ⅲ-Ⅳ degree of pressure sores BU Lingmei (The First Orthopedics Unit of Anyang Iron Steel Group Company General Hospital, Henan Province, Anyang455004, China) [Abstract] Objective: To investigate the clinical effects of the rubber myogenic cream for treatment myogenic Ⅲ, IV degree of bedsore to offer a new method of treatment of pressure sores. Methods: Beginning we took the traditional method of wound dressing, the effect was not obvious, we switch to regular stand up, general comprehensive care, psychological care and rehabilitation training, plus Rubber myogenic cream dressing. Results: Ⅲ stage bedsore had been healed in 5 weeks and Ⅳ stage bedsore had been largely healed in 6 weeks, and achieved very satisfactory therapeutic effect. Conclusion: Rubber myogenic cream for treatment of myogenic Ⅲ, Ⅳ bedsore has better therapeutic effect, it is worth for clinical use. [Key words] Decubitus; Rubber myogenic cream 压疮是身体局部组织长期受压,血液循环障碍,组织营养缺乏,致使皮肤失去正常功能而引起的组织破损和坏死[1]。压疮一旦发生,不但增加患者的痛苦,而且增加医疗费用[2]。脊髓损伤伴有截瘫的患者,极易发生压疮,若处理不当则会造成感染严重危及患者的生命[3]。创面采取象皮生肌膏换药的方法,不仅减轻患者的痛苦,缩短住院时间,也降低了医疗费用,效果较好。现报道如下: 1资料与方法 1.1一般资料 选择2007年1月~2008年12月入院的患者。本组8例,年龄40~55岁,均属高空坠落伤;男6例,女2例,术后卧床3~6个月;其中颈椎骨折内固定术后伴高位截瘫5例,腰椎骨折内固定术后伴截瘫3例,查体:患者意识清,精神差,形态消瘦,贫血貌,被动体位。日常生活活动能力评定Barthel指数[4]评分为5分。IV期压疮并感染,均发生于骶尾部,面积(3～5) cm×(4～5) cm,都深达肌层,表面可见大量白色脓性分泌物,有恶臭。左、右髋部、骶尾部分别有2 cm×4 cm、3 cm×4 cm、5 cm×3 cm的Ⅲ期压疮,创面发黑,边缘皮肤红肿。 1.2方法 1.2.1局部创面护理①象皮生肌膏(天津医院配制)换药方法。首先用双氧水、生理盐水消毒创面,去除创面分泌物及坏死组织,充分暴露相对健康组织,使其创面少量渗血,将象皮生肌膏摊于脱脂棉上敷患处,然后给予棉垫外敷。开始渗出液较多,换药根据创面渗出情况每日一次或隔日一次,随着创面渗出液明显减少可改为每2~3天换药一次 ,直至痊愈。②注意局部用药的疗效。根据国家中药管理局发布的《中医病症诊断疗效标准》,治愈:创面结痂愈合;有效:创面缩小,肉芽新鲜;无效:创面未愈合[5]。先后曾用碘伏、甲硝唑、生鸡蛋内膜