封闭式负压引流治疗脑出血患者的压疮护理

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封闭式负压引流治疗脑出血患者的压疮护理

作者：常波 余国勇 郑桂周 李学东 来源：《中国实用医药》2014年第15期

【摘要】目的探讨封闭式负压引流(VSD)治疗脑出血患者压疮的护理。方法将本院收治的48例脑出血并发压疮患者分为实验组和对照组, 对照组予以常规压疮护理, 实验组是压疮护理结合VSD治疗。结果实验组有效率为 85.7% , 对照组55.0%, 两组疗效差异具有统计学意义(P 【关键词】封闭式负压引流；脑出血 ；压疮；护理

VSD treatment and nursing for cerebral hemorrhage patients with pressure sore CHANG Bo, YU Guo-yong, ZHENG Gui-zhou, et al. Department of Neurosurgery, First Affiliated Hospital of Medical College of Shantou University, Shantou 515041, China

【Abstract】 Objective To investigate the outcome of the vacuum sealing drainage (VSD) technique for pressure sores patients with cerebral hemorrhage. Methods From January 2012 to July 2013, 48 cases of cerebral hemorrhage patients complicated with severe pressure sores were divided into the control group and experimental group in our hospital. The control group accepted pressure sores nursing, the experimental group treated with VSD combined with nursing. Results The total effective rate was 85.7% in experimental group, while 55.0% in control group. There was a significant difference between the two groups(P

【Key words】 Vacuum sealing drainage; Cerebral hemorrhage; Pressure sore; Nursing脑出血是中、老年人常见疾病, 其发病率高, 起病急, 病情复杂, 致残率和死亡率高, 对老年健康及生活质量造成严重威胁；目前缺乏有效的根治方法, 极易引发各种并发症。压疮是长期卧床的患者的主要并发症。综合性医院的院内压疮发生率为3%~14%［1］。压疮根据其病理变化的分四期［2］：I期：淤血红润期, 此期损伤仅限于表皮, 受损皮肤呈暗红色, 可伴有热、肿、痛。解除对该部位的压力30 min仍不能恢复正常的皮肤颜色；Ⅱ期：炎性浸润期, 损伤透过表皮延伸到皮下脂肪层, 受损皮肤表面呈紫红色, 触之有硬结, 可形成完整的或开放性的充血性水泡, 水泡破溃后形成一个浅的开放性溃疡；Ⅲ期：浅度溃疡期, 为浅层组织 感染、化脓形成溃疡；Ⅳ期：深度溃疡期, 损伤可深及皮下及深层组织, 为全层皮肤及骨骼、肌肉坏死, 溃疡可达骨面, 坏死组织发黑且有臭味。

封闭负压引流( vacuum sealing drainage, VSD)是指使用含有引流管的医用海绵敷料, 用其覆盖或者填充皮肤、创面, 再将生物半透膜对其进行封闭, 使其成为密闭空间, 最后把引流管接通负压源, 利用可以控制的负压促进创面愈合的新型治疗方法［3］。本研究采用合理的护理结合VSD治疗脑出血并发的Ⅲ、Ⅳ期压疮的患者, 收到了较好的疗效, 结果报告如下。 1资料与方法