摘要:
Objective To investigate the efficacy and patient satisfaction in the treatment of 30 patients with Ⅲ-stage pressure ulcer of diabetic nephropathy by hyperbaric oxygen (HBO) combined with infrared radiation and silver sulfadiazine cream.Methods Sixty diabetic nephropathy patients with Ⅲ-stage pressure ulcer hospitalized in Yantaishan Hospital from January 2015 to January 2018 were randomly divided into the observation group and the control group,each consisting of 30 patients.The control group was additionally treated with infrared irradiation and silver sulfadiazine cream on the basis of routine treatment,while the observation group was supplemented with HBO in addition to the treatment received by the control group.After 4 courses of treatment,the therapeutic effect,healing time,pain scores and patient satisfaction were compared between the patients of the 2 groups.Results The cure rate (46.7%) and total effective rate (93.3%) of the observation group were significantly higher than those (16.7% and 70.0%) of the control group,and statistical significance could be seen when comparisons were made between the 2 groups (P <0.05).Average healing time of the observation group [(14.02 ± 2.68) d] was significantly shorter than that of the control group[(22.19 ± 3.81)d],and statistical significance could also be noted when comparisons were made between them (P < 0.05).After 7,14,21 and 28 days of treatment,the VAS pain scores of the observation group were significantly lower than those of the control group (P < 0.05 or P < 0.01).Total effective rate of the observation group was higher than that of the control group,and the average healing time of the observation group was less than that of the control group.Patient satisfaction of the observation group was higher than that of the control group (P < 0.05).Conclusion HBO combined with infrared irradiation and silver sulfadiazine cream in the treatment of Ⅲ-stage pressure ulcer in patients with diabetic nephropathy could significantly improve treatment efficacy,shorten healing time,improve the quality of wound healing,alleviate the pain of patients and increase patient satisfaction.For this reason,it was worth further clinical application.%目的 探讨高压氧(hyperbaric oxygen,HBO)联合红外线照射及磺胺嘧啶银乳膏治疗糖尿病肾病Ⅲ期压疮患者30例疗效及患者满意度.方法 选取2015年1月至2018年1月烟台山医院住院治疗的糖尿病肾病合并Ⅲ期压疮患者60例,按照数字表法随机分为观察组和对照组,每组30例.对照组采用常规治疗的基础上加用红外线照射及磺胺嘧啶银乳膏治疗;观察组在对照组治疗的基础上加用HBO治疗.治疗4个疗程后,比较2组患者的压疮治疗效果、愈合时间、疼痛评分及患者满意度.结果 观察组患者治愈率(46.7%)和总有效率(93.3%)均明显高于对照组治愈率(16.7%)和总有效率(70.0%),差异均有统计学意义(P<0.05);观察组平均愈合时间[(14.02±2.68)d]明显少于对照组[(22.19±3.81)d],差异有统计学意义(P<0.05);观察组患者治疗7、14、21和28 d VAS疼痛评分明显低于对照组(P<O.05或P<0.01),观察组平均愈合天数少于对照组,满意度高于对照组(均P<0.05).结论 HBO联用红外线照射及磺胺嘧啶银乳膏治疗糖尿病肾病患者Ⅲ期压疮能明显提高治疗有效率,缩短愈合时间,提高压疮创面修复质量,减轻患者痛苦,提升患者的满意度,值得临床进一步推广应用.