Undertaking leg ulcer research in primary care

Evidence-based practice has become a by-word in leg ulcer care, but the picture is far from complete. More research is needed. Carrying out the research to ensure quality care in a primary care setting brings practical difficulties and raises issues which must be resolved, as a research team from Birmingham University shows.     

Developing a framework to assess competence in leg ulcer care

To provide effective and safe patient care, it is imperative for all practitioners to possess a core set of skills. This paper describes the development of a framework for assessment of competence in carrying out Doppler assessments and compression bandaging for practitioners involved in caring for patients with leg ulcers in one institute of higher education.     

坏疽性脓皮病患者溃疡伤口的整体干预

目的 探讨1例坏疽性脓皮病溃疡伤口的处理方法及效果.方法 复习相关文献,分析本例坏疽性脓皮病溃疡伤口的难点和特点,分别给予银离子敷料联合红外线照射治疗伤口、28%高渗盐敷料联合红外线照射治疗、28%高渗盐敷料联合超短波治疗和蜂蜜敷料局部治疗结合药物治疗.观察指标:于每次处理伤口前评估测量伤口面积、疼痛和愈合计分.结果 不同方法处理伤口后疼痛计分持续下降,但伤口出现变形和扩展,愈合计分随之增加.动态调整方法后,2处溃疡伤口均治愈,愈合时间分别为105d和172d,随访2个月无复发.结论 整体干预结合局部动态调整是有效处理坏疽性脓皮病溃疡伤口的方法.     

Recommendations for leg ulcer care in acute trusts

Lucy Aldeen describes recommendations that aim to assist tissue viability nurses and managers in acute trusts to implement guidelines on leg ulcer management. The goal is to improve and sustain standards of care for this patient group.     

膜性肾病合并抗中性粒细胞胞质抗体阴性血管炎一例报告及文献复习

病例:患者,男,84岁,因"双下肢浮肿伴泡沫尿2个月,肾功能异常1个月"入我院诊治。入我院前2个月,患者自觉双下肢胫前区轻度浮肿,同时有尿中泡沫增多,遂至外院就诊。外院查尿常规示,尿蛋白(+++),红细胞(RBC)(-),尿蛋白定量1 130 mg/24 h;血清白蛋白(ALB)40 g/L,血肌酐(Scr)83μmol/L,抗中性粒细胞胞质抗体(ANCA)(-)。外院予缬沙坦(代文)治疗后,患者症     

Pressure ulcer benchmarking within a primary care setting

Patient-focused benchmarking was initially launched by the Department of Health. This article examines how the tissue viability service of Camden and Islington primary care trusts implemented the pressure of ulcer benchmarking process within the nursing teams of these trusts. This was achieved by: agreeing best practice through examination of local and national guidelines; developing a suitable audit tool for nursing teams to assess their clinical areas against this best practice; nursing teams producing core action plans to facilitate movement towards best practice; disseminating results; reauditing. The results of the audits carried out in October 2003 and February 2004 are presented. A plan for future work is described including: the involvement of other members of the multidisciplinary team and the Patient Advice Liaison Service; linking pressure ulcer benchmarking to the benchmarks of communication, privacy and dignity and record keeping.     

Living with a venous leg ulcer: a descriptive study of patients''experiences

This paper examines the progress made in the measurement of the 'outcomes' of nursing Although nursing has a long history of outcome research which extends as far back as Florence Nightingale, an examination of the literature over the past 30 years gives little impression of progress Significant difficulties still remain in identifying outcomes relevant to nursing intervention, measurement techniques and appropriate study designs However, progress has been made The paper examines various recent trends which point to ways forward for outcome research In particular it is emphasized that future work should build upon the strengths of past work in the use of measurement tools and the identification of relevant variables Outcome research in nursing should not be limited to identifying the immediate results of nursing intervention, nor should research into 'structure' or 'process' variables be neglected Such concepts are vital to determining the nursing contribution to changes in a patient's health and well being The future of outcome research depends on a range of appropriate research methods and measurement techniques     

1例糖尿病足部溃疡病人的护理

目前,全世界糖尿病病人中有15.5%的病人发生糖尿病足[1]。虽然治疗糖尿病足的方法很多,但常会给病人带来不同程度的痛苦,尤其截肢给病人造成精神和身体的重大创伤。2005年6月,我科成功护理1例糖尿病足部溃疡的病人,避免了截肢。现将护理体会介绍如下。1病例介绍病人,女,60岁,于2004年4月4日以足痛4个多月加重1个月,不能入睡住院。查体:体温37℃,脉搏80/min,血压18.4/11.3kPa,左侧偏瘫,活动严重受限。左下肢、足背有一坏疽伤口,12.0cm×11.0cm×0.5cm,足背筋膜暴露,变硬发黑,整个伤口黑痂面积达100%,周边皮肤发红,稍有水肿。彩超显示:双侧…     

1例糖尿病足部溃疡病人的护理

目前，全世界糖尿病病人中有15.5%的病人发生糖尿病足，虽然治疗糖尿病足的方法很多，量常会给病人带来不同程度的痛苦，尤其截肢给病人造成精神和身体的重大创伤。2005年6月，我科成功护理1例糖尿病足部溃疡的病人，避免了截肢，现将护理体会介绍如下。     

1例背部巨大皮肤癌性溃疡病人的护理

大面积皮肤溃疡治疗相当棘手。除了对症治疗、全身治疗、溃疡面换药治疗外 ,常需通过显微外科手术治疗方可封闭溃疡面[1] 。大面积皮肤溃疡血液循环不良 ,常伴有严重的细菌污染或感染 ,采用皮肤移植修复溃疡面是常用的治疗方法。我科于2 0 0 1年应用自体中厚皮片移植修复背部巨     

Actico: a short-stretch bandage in venous leg ulcer management

Actico compression bandage system (Activa Healthcare) completes the prevention and treatment regime of venous leg ulcer management. Actico gives the patient comfort by being a simple two-layer compression bandage system that is also effective and which stays in place because of its cohesive nature. This product focus looks at the impact of venous leg ulcers, the use of compression and focuses on short-stretch bandages and the Actico bandage system.     

丙基硫氧嘧啶相关性血管炎合并急性肾损伤一例并文献复习

目的报告1例由于服用丙基硫氧嘧啶(PTU)导致抗中性粒细胞胞浆抗体(ANCA)阳性的血管炎合并急性肾损伤。方法收集患者的病史、实验室血清学及肾活组织病理检查结果,分析其诊断及治疗,并对PTU相关性血管炎文献进行综述。结果 15岁女性患者,以突发少尿、蛋白尿起病,迅速进展至肾功能衰竭,血MPO-ANCA检查阳性,肾活检病理提示:(1)肾小球节段坏死性病变及新月体(5/7),结合病史考虑ANCA相关性血管炎(PTU相关);(2)肾小球节段毛细血管内增生性病变,免疫荧光以C3沉积为主。结合患儿有原发性甲状腺功能亢进病史,服用PTU治疗3年,明确诊断为(1)PTU相关性血管炎;(2)急性肾损伤,立即停用PTU,给予血浆置换4次及甲泼尼龙冲击治疗3个疗程后,患儿肾功能恢复,尿量正常。随访4个月各项检查指标恢复正常。结论 PTU可导致ANCA阳性的血管炎合并急性肾损伤,及时诊治可改善预后。