糜蛋白酶冲洗联合清创术治疗III期褥疮疗效70例观察.docVIP

糜蛋白酶冲洗联合清创术治疗III期褥疮疗效70例观察 　　摘 要 目的：探讨糜蛋白酶联合清创术对促进III期褥疮愈合的治疗作用。方法：将近5年（2006-2011年）收集的70例III期褥疮的患者分为治疗组与对照组，在基本治疗方法不变的情况下，治疗组加用糜蛋白酶治疗，比较两组脓性分泌物坚守和消失时间。结果：治疗1周后，治疗组的效果明显高于对照组，两组差异有统计学意义。且治疗组的其他指标均有显著改善。结论：治疗III期褥疮在重视加强营养的同时，联合糜蛋白酶清创治疗褥疮明显缩短愈合时间，可推广应用。 　　关键词 糜蛋白酶 III期褥疮 清创术 　　中图分类号：R456.3； R632.1 文献标识码：B 文章编号：1006-1533（2013）11-0025-03 　　Observation of the efficacy of combination of chymotrypsin flush 　　with debridement in the treatment of 70 cases of phase III decubitus 　　WANG Jianxiong1， XIE Yanqiu2*， GAO Hongyun1， WANG Zhijun1， CHEN Yanqing1， WANG Sheng1 　　（1. Dept. of Emergency ， The Tenth People’s Hospital， Tongji University， Shanghai 200072， China； 　　2. 266th Hospital of the PLA Beijing Military Region， Chengde 067000， China） 　　ABSTRACT Objective： To investigate the therapeutic effect of chymotrypsin plus debridement on the phase III bedsore healing. Methods： Seventy patients with phase III bedsore collected in recent five years （2006-2011） were divided into either a treatment group or a control group. Patients in the treatment group were additionally treated with chymotrypsin besides the basic treatment. Purulent secretions stick and disappearance time between these two groups were compared. Results： After one week treatment， the efficacy in the treatment group was significantly higher than that in the control group and the difference between them was statistically significant. Other indicators in the treatment group were significantly improved as compared with the control group. Conclusion： Combination of chymotrypsin with debridement in the treatment of the phase III bedsore can significantly shorten the healing time at the same time to strengthen nutrition. 　　KEY WORDS chymotrypsin； phase III bedsore； debridement 　　褥疮又称压疮[1]，是长期卧床患者常见的并发症，治疗护理很棘手。第III期褥疮是浅度溃疡期，即表皮破损、溃疡形成，是褥疮比较严重的阶段。其典型特征为全层皮肤组织缺失，可见皮下脂肪暴露，但骨头、肌腱、肌肉未外露，有腐肉存在，组织缺失的深度不明确，可能包含有潜行和隧道。若范围较小，创面处理及时，方法有效，创面可靠溃疡四周上皮爬行而覆盖。若继发感染，组织将被继续破坏向深层发展，有脓性分泌物。溃疡长期不能愈合时，四周边缘将形成厚而坚硬的瘢痕组织，阻止了创面的收缩，加重了