威伐光照射联合京万红软膏治疗糖尿病压疮的临床效果

麦凤娇 孟庆奇 曾德良

[摘要]目的 探讨威伐光照射联合京万红软膏治疗糖尿病压疮的临床效果。方法 纳入2018年3月～2019年9月广州市红十字会医院康复科收治的60例糖尿病压疮患者作为研究对象，根据随机数字表法将患者分为两组（n=30）。所有患者均首先接受常规处理，对照组患者采用京万红软膏治疗，观察组患者在对照组基础上联合威伐光照射，观察并分析两组患者治疗后的临床效果、临床指标、创面愈合情况及生活质量。结果 观察组患者的总有效率为96.67%，高于对照组的80.00%，差异有统计学意义（P<0.05）;观察组患者的水泡吸收时间为（2.04±0.43）d、表面结痂时间为（3.16±0.46）d、压疮愈合时间为（8.13±1.07）d，均短于对照组的（3.58±1.22）、（5.16±1.51）、（12.67±1.61）d，观察组患者的换药次数为（9.25±2.07）次，少于对照组的（11.43±2.13）次，观察组患者的视觉模拟量表（VAS）评分为（1.16±0.08）分，低于对照组的（1.45±0.19）分，差异均有统计学意义（P<0.05）;观察组患者治疗前的压疮愈合评价量表（PUSH）和世界衛生组织生存质量测定量表简表（WHOQOL-Bref）评分为（7.85±1.16）、（51.16±7.59）分，对照组为（7.59±1.08）、（51.37±7.65）分，两组比较，差异无统计学意义（P>0.05）;治疗后，观察组患者的PUSH评分为（4.38±0.86）分，低于对照组的（5.17±0.94）分，观察组患者的WHOQOL-Bref评分为（65.18±8.73）分，高于对照组的（60.07±7.86）分，差异有统计学意义（P<0.05）。结论 威伐光照射联合京万红软膏治疗糖尿病压疮效果较好，可迅速改善症状，促进创面愈合，减少换药次数，减轻疼痛，提高患者的生活质量。

[关键词]威伐光照射;京万红软膏;糖尿病;压疮

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1674-4721（2020）7（c）-0057-04

Clinical effect of water-filtered infrared-A irradiation combined with Jingwanhong Ointment in the treament of diabetic pressure ulcers

MAI Feng-jiao   MENG Qing-qi   ZENG De-liang

Department of Rehabilitation， Guangzhou Red Cross Hospital， Guangdong Province， Guangzhou   510220， China

[Abstract] Objective To investigate the clinical effect of water-filtered infrared-A irradiation combined with Jingwanhong Ointment in the treament of diabetic pressure ulcers. Methods A total of 60 patients with diabetic pressure ulcers admitted to the Department of Rehabilitation， Guangzhou Red Cross Hospital from March 2018 to September 2019 were selected as the research objects， dividing patients into two groups （n=30） according to the random number table method. All patients received routine treatment first， the patients in the control group was treated with Jingwanhong Ointment， the patients in observation group was treated with water-filtered infrared-A irradiation treatment on the basis of the control group， The clinical efficacy， clinical indicators， wound healing and quality of life of the two groups patients after treatment were observed and analyzed. Results The total effective rate in the observation group was 96.67%， which was higher than 80.00% in the control group， the difference was statistically significant（P<0.05）. In the observation group blister absorption time was （2.04±0.43） d， surface scab time was （3.16±0.46） d， pressure ulcer healing time was （8.13±1.07） d， which were shorter than （3.58±1.22）， （5.16±1.51）， （12.67±1.61） d in the control group， the number of dressing changes in the observation group was （9.25±2.07） times， fewer than （11.43±2.13） times in the control group， and the visual analogue scale （VAS） score of the observation group was （1.16±0.08） points， lower than that in the control group of （1.45±0.19） points， the differences were statistically significant （P<0.05）. The observation group′s pressure ulcer scale for healing （PUSH） and the World Health Organization Quality of Life Questionnaire-Brief Version （WHOQOL-Bref） scores before treatment were （7.85±1.16） and （51.16±7.59） points， the control group were （7.59±1.08） and （51.37±7.65） points， there were no significant differences between the two groups （P>0.05）. After treatment， the PUSH score of the observation group was （4.38±0.86） points， which was lower than （5.17±0.94） points in the control group， the WHOQOL-Bref score of the observation group was （65.18±8.73） points， higher than that of the control group of （60.07±7.86） points， the differences were statistically significant （P<0.05）. Conclusion Water-filtered infrared-A combined with Jingwanhong Ointment has better effect on diabetic pressure ulcers， can quickly improve symptoms， promote wound healing， reduce the number of dressing changes， reduce pain， and improve patients′ quality of life.

[Key words] Water-filtered infrared-A; Jingwanhong Ointment; Diabetes mellitus; Pressure ulcers

压疮又称压力性溃疡、褥疮，该症多因局部组织长期受压，发生持续缺血、缺氧、营养不良而导致组织溃烂坏死，尤其是Ⅲ、Ⅳ期压疮，因受压皮肤全层组织破溃，慢性窦道形成，且深及肌腱、骨骼并发骨髓炎、骨坏死、感染和大量营养丢失的风险大大增加，创面更加难以愈合[1]。糖尿病（DM）患者存在神经末梢循环障碍，易发生压疮。DM压疮患者皮肤破溃后，创面愈合时间较长，增加了感染的风险[2]。另外，压疮的发生不仅会加重患者的痛苦和经济负担，其相关并发症还会导致患者死亡。京万红软膏是治疗压疮的常用药物，具有消肿止痛、祛腐生肌的作用，但单一用药治疗时间长，疗效有限。……