湿性愈合法在慢性伤口愈合护理中的效果观察

目的探析湿性愈合法在慢性伤口愈合护理中的应用效果。方法选择本院2015年1月~2016年12月慢性伤口患者100例,依据随机数字表法将全部患者平均分成对照组、观察组各50例,分别选择不同的伤口愈合护理方法进行护理,比较其效果。结果观察组愈合总有效率为92.00%,对照组总有效率为76.00%;观察组伤口黑期、黄期以及红期愈合时间均短于对照组。结论湿性愈合法应用在慢性伤口愈合护理中可以加快伤口愈合,值得推广应用。     

银离子敷料在下肢及足部慢性伤口创面护理中的应用

目的比较银离子敷料与普通敷料治疗在下肢及足部慢性伤El中的效果。方法选取门诊下肢及足部慢性伤口患者共46例随机分为银离子敷料组和普通敷料组,每组各23例。分别记录患者就诊时、换药1周后、换药2周后的视觉疼痛评分（VAS）和伤口创面评分（WBS）。结果银离子敷料组和普通敷料组就诊时、换药1周后和换药2周后WBS评分分别为[（5．8±1．73）分比（5．9±1．83）分,（10．5±1．03）分比（9．1±1．25）分,（14．0±1．26）分比（12．4±1．27）分],就诊时,两组差异无统计学意义（t=-0．248,P〉0．05）;换药1周后和换药2周后两组差异有统计学意义（t分别为3．969,3．957;P均〈0．01）。银离子敷料组和普通敷料组就诊时、换药1周后和换药2周后VAS评分分别为[（5．2±1．14）分比（5．1±1．07）分,（2．0±0．67）分比（3．1±0．65）分,（0．9±O．63）分比（1．3±0．83）分],就诊时和换药2周后,两组差异无统计学意义（￡分别为-0．133,-1．790;P均〉0．05）;换药1周后两组差异有统计学意义（t=-6．010,P〈0．01）。结论银离子敷料的换药效果较普通敷料的换药效果更好,更利于伤口愈合,更有助于减轻早期疼痛。     

标准化伤口护理程序在慢性伤口护理中的应用

目的探讨标准化伤口护理程序在慢性伤口护理中的实施效果。方法选取2019年1月—11月在伤口护理中心就诊的慢性伤口患者151例,采用随机数字表法将患者分为对照组(n=76)和观察组(n=75),对照组实施常规伤口护理方案,观察组实施标准化伤口护理程序。比较2组伤口愈合时间和患者对护理的满意度。结果观察组外伤性溃疡、术后切口延迟愈合、压力性损伤患者的伤口愈合时间均短于对照组,差异有统计学意义(P<0.05)。观察组患者对护理的满意度高于对照组(P<0.05)。结论对慢性伤口采用标准化护理程序能有效缩短慢性伤口护理过程,提高患者满意度。     

叙事护理在慢性伤口患者中的应用效果观察

目的 探讨叙事护理对慢性伤口患者心理状态和生活质量的影响。方法 选取2019年7月—2021年7月医院收治的80例慢性伤口患者为研究对象,按照组间基本资料匹配的原则分为对照组和观察组,各40例。对照组采用常规护理,观察组在对照组基础上实施叙事护理,两组均持续干预4周。比较两组伤口愈合时间、心理状态、生活质量和护理满意度。结果 观察组患者伤口愈合时间较对照组短,差异有统计学意义（P<0.05）。干预前,两组患者心理状态和生活质量评分比较差异无统计学意义（P>0.05）;干预后,观察组焦虑自评量表、抑郁自评量表评分较对照组低,差异有统计学意义（P<0.05）;干预后,观察组患者生活质量评分较对照组高,差异有统计学意义（P<0.05）。观察组护理满意度高于对照组,差异有统计学意义（P<0.05）。结论 慢性伤口患者接受叙事护理,可减轻患者焦虑、抑郁情绪,促进患者伤口愈合,提高生活质量,从而提升护理满意度。     

延续性护理在外科门诊患者慢性伤口愈合中的应用

目的:探讨延续性护理在外科门诊患者慢性伤口愈合中的应用效果。方法:将2017年1月1日～2019年6月30日外科门诊就诊的80例慢性伤口患者随机分为实验组和对照组各40例,对照组采用常规护理措施,实验组在常规护理基础上实施延续性护理干预。比较两组患者治疗效果、伤口愈合时间、伤口换药次数及两次换药间隔时间,同时对患者的护理服务满意情况进行评定。结果:实验组患者治疗有效率、各项护理服务评分均高于对照组(P0.05),实验组伤口愈合时间、两次换药间隔时间短于对照组(P0.05),实验组伤口换药次数少于对照组(P0.05)。结论:延续性护理可以有效促进患者伤口愈合,减少患者伤口换药次数,提高患者治疗依从性,同时减轻了患者的经济压力。     

湿性愈合法在术后伤口愈合护理中的应用效果

目的 探讨湿性愈合法在术后伤口愈合护理中的应用和对护理结局优良率的影响。方法 选取我院2020年4月至2021年4月手术治疗患者83例,按照治疗方法分为试验组42例和对照组41例,对照组采用常规愈合护理,试验组在对照组基础上采用湿性愈合法护理,对比两组换药次数、治疗费用、伤口愈合时间、护理结局优良率、护理满意度。结果 试验组换药次数和治疗费用少于对照组(P<0.05);红期、黄期、黑期伤口愈合时间短于对照组(P<0.05);护理结局优良率92.86%(39/42)高于对照组78.05%(32/41)(P<0.05);护理满意度95.24%(40/42)高于对照组80.49%(33/41)(P<0.05)。结论 湿性愈合法应用于术后伤口愈合护理中,可缩短伤口愈合时间,提高护理结局优良率和满意度,值得临床推广应用。     

品管圈在慢性创面病人护理中的应用

[目的]探讨品管圈(QCC)在慢性创面病人护理中的应用效果。[方法]按照随机数字表法将2017年1月—2018年2月接诊的80例慢性创面病人分为观察组和对照组各40例,对照组病人接受常规综合护理,观察组病人在常规综合护理基础上开展QCC活动。就诊时及就诊后2周采用视觉模拟评分法(VAS)评估疼痛情况,采用加的夫伤口影响量表(CWIS)评估生活质量,比较两组病人临床疗效、就诊后疼痛和生活质量以及护理满意度情况。[结果]观察组病人治疗总有效率高于对照组(P0.05);观察组病人就诊后2周VAS低于对照组,CWIS评分高于对照组(P0.05);观察组护理人员职业素养自评评分高于对照组(P0.05)。[结论]在慢性创面病人护理中开展QCC能够有效改善病人预后、提高生活质量和护理人员综合素质。     

慢性伤口护理研究进展

本文从伤口愈合理论、伤口敷料的选择、伤口护理技术三个方面综述近年来国内外伤口护理研究进展.指出仍存在许多问题需要进一步研究,如伤口局部封闭负压引流的压力范围,吸引方式,伤口不同时期敷料的针对性选择等.随着循证护理的发展和高层次护理人员和增加,伤口护理实践将会变得更加系统、规范.     

Effectiveness of fire needle combining with moist healing dressing to promote the growth of granulation tissue in chronic wounds: A case report

In this case study, we analyzed the wound-healing process of a patient with a chronic wound who underwent fire needle treatment, and we tracked the coverage of granulation tissue and decrease of slough and exudate. An 85-year-old man had repeated right shoulder and back pain, itching, and skin festering for more than 1.5 years. A fire needle was administered combined with moist dressing once every 5 days to promote wound healing. After six rounds of fire needle treatment, granulation tissue formed over the surface of the wound base, the depth of the wound had become shallow, and the wound area was reduced. No complications occurred during the intervention. Fire needle therapy combined with a moist wound-healing dressing can be an effective alternative approach in managing chronic wounds.     

Basal cutaneous pain threshold in headache patients

The aim of this study was to analyze cutaneous pain threshold (CPT) during the interictal phase in headache patients, and the relationships between headache frequency and analgesic use. A consecutive series of 98 headache patients and 26 sex- and age-balanced controls were evaluated. Acute allodynia (AA) was assessed by Jakubowski questionnaire, and interictal allodynia (IA) by a skin test with calibrated monofilaments. AA is widely known as a symptom more present in migraine than in TTH spectrum: in our study this was confirmed only in cases of episodic attacks. When headache index rises towards chronicization, the prevalence of AA increases in both headache spectrums (χ ² 13.55; p < 0.01). AA was associated with IA only in cases of chronic headache. When headache becomes chronic, mostly in presence of medication overuse, interictal CPT decreases and IA prevalence increases (χ ² 20.44; p < 0.01), with closer association than AA. In MOH patients there were no significant differences depending on the diagnosis of starting headache (migraine or tension type headache) and, in both groups, we found the overuse of analgesics plays an important role: intake of more than one daily drug dramatically reduces the CPT (p < 0.05). Thus, when acute allodynia increases frequency, worsens or appears for the first time in patients with a long-standing history of chronic headache, it could reasonably suggest that the reduction of CPT had started, without using a specific practical skin test but simply by questioning clinical headache history. In conclusion, these results indicate that the role of medication overuse is more important than chronicization in lowering CPT, and suggest that prolonged periods of medication overuse can interfere with pain perception by a reduction of the pain threshold that facilitates the onset of every new attack leading to chronicization.     

Gender role expectations of pain is associated with pain tolerance limit but not with pain threshold

Gender role expectations of pain (GREP) was suggested to predict sex differences in pain perception. Our aim was to explore sex differences in GREP and investigate its relationship with heat-pain threshold (HPT) and heat-pain tolerance limit (HPTL). University students (115 males, 134 females) filled the GREP questionnaire. HPT and HPTL were measured in a sample of 72 students. Additionally, GREP values of the present sample were compared with those of the original, American sample to explore possible cultural effects.Both males and females perceive themselves (and their own sex in general) to be less sensitive to pain and less willing to report of pain than the opposite sex. Males perceived themselves and other men, to endure pain relatively similar to women whereas females perceived themselves and other women as less endurable to pain than men. HPT was similar for the two sexes but males had higher HPTL than females. Within each sex, HPTL correlated mainly with self’s perception of pain sensitivity. The American and Israeli samples differed in that Israeli males and females presented stronger stereotypical views towards same and opposite sexes.Both males and females held stereotypical “macho” attitude towards themselves with regard to pain sensitivity and willingness to report of pain however only females held stereotypical, “macho” attitude towards themselves with regard to pain endurance. The sex differences in GREP and in HPTL and the correlations between GREP items and experimental thresholds suggest that the relationship between GREP and experimental pain is complex and sex-specific. It also appears that GREP is affected by culture.     

深度烧伤患者创面护理干预措施探讨

目的：探讨深度烧伤患者创面护理干预措施。方法收集2009年3月～2013年10月在本院治疗的深度烧伤患者21例作为观察组,并选取同时住院的24例患者作为对照组,观察组采用综合护理措施,对照组给予常规护理,收集观察组和对照组患者第1周、第2周的残余创面细菌培养资料,残余创面平均愈合时间资料,并进行统计分析。结果观察组残余创面第1周细菌培养阳性率和阴性率分别为38．09％和61．91％,对照组为70．83％和29．17％,观察组残余创面第2周细菌培养阳性率和阴性率分别为14．29％和85．71％,对照组分别为58．33％和41．67％,两组比较组间差异有统计学意义（P＜0?05）;观察组的残余创面愈合时间为（21．5±3．6）d,对照组为（29．7±6．0）d,差异具有统计学意义（P＜0?05）。结论深度烧伤患者采取综合护理干预,创面细菌数较少,愈合时间短,具有较大的临床推广价值。     

Effects of Integrated Neuromuscular Inhibition Technique on pain threshold and pain intensity in patients with upper trapezius trigger points

Introduction

Upper trapezius trigger points are among the most common causes of neck pain. This study aimed to investigate the effects of integrated Neuromuscular Inhibition Technique (INIT) on pain intensity and threshold.

骨科慢性疼痛患者疼痛灾难化与疼痛强度、情绪状态的关系

目的 了解骨科慢性疼痛患者疼痛灾难化现状,探索疼痛强度、情绪状态与疼痛灾难化的关系。方法 采用方便抽样的方法选择某三甲医院骨科慢性疼痛患者262例作为研究对象,采用一般资料调查表、疼痛数字评分表(number rating scale,NRS)、疼痛灾难化量表(pain catastrophizing scale,PCS)、正性负性情绪量表(positive and negative affect schedule,PANAS)对其进行调查。结果 骨科慢性疼痛患者NRS、PANAS和PCS评分分别为(6.59±2.31)、(64.94±11.45)和(34.51±9.63)分。不同居住方式、是否有配偶的患者间PCS得分比较,差异均有统计学意义(t=2.021,P=0.042; t=2.724,P=0.012),PCS和NRS、PANAS-PA、PANAS-NA间的相关系数(r)分别为0.397、-0.325和0.388(均P<0.01),多元线性回归结果显示疼痛强度和情绪状态对疼痛灾难化具有预测作用。结论 骨科慢性疼痛患者疼痛强度、情绪状态和疼痛灾难化呈中等程度相关,疼痛干预、增强社会支持和负性情绪与积极心理干预是减低疼痛灾难化的可能措施。     

慢性疼痛患者疼痛信念研究的范围综述

目的 对国内外慢性疼痛患者疼痛信念相关研究进行范围综述,了解疼痛信念在慢性疼痛领域的研究现状。方法 根据范围综述的研究方法,计算机检索PubMed、CINAHL、Web of Science、中国知网、万方数据库、维普数据库、中国生物医学文献数据库和中华医学期刊全文数据库中的相关研究。检索时限为建库至2022年2月28日。对纳入文献进行分析和讨论。结果 最终纳入21篇文献,其中4篇随机对照试验、4篇类实验研究、13篇横断面研究。疼痛信念相关理论框架包括恐惧-回避模型、自我效能理论、ABC理论、自我调节常识模型和关系框架理论。评估工具可分为疼痛鉴别信念、原因信念、后果信念和可控性信念评估4类。干预方法主要包括认知行为疗法、接纳与承诺疗法和疼痛健康教育3种类型。结论 国内护理研究者应重视慢性疼痛患者疼痛信念相关理论框架的发展和完善,并在其指导下选择规范统一的评价工具,依据慢性疼痛患者的疼痛信念现状,制订科学、适用和规范的疼痛信念修正干预方案。     

两种皮肤保护方法在负压治疗慢性伤口中的应用研究

目的 探索两种皮肤保护方法对预防负压伤口治疗相关的潮湿相关性皮肤损伤的效果。方法 纳入具有负压伤口治疗适应证的慢性伤口患者132例,随机分为两组,每组各66例。试验组采用防漏膏封堵伤口周围皮肤保护法,对照组采用多聚合物无痛皮肤保护膜涂抹法,两组均干预14 d后,使用标准的湿性治疗随访至愈合或3个月。评价指标：负压治疗期间伤口周围皮肤潮湿相关性皮肤损伤发生率为主要结局指标,负压治疗过程中的漏气报警和皮肤浸渍频次、伤口面积、深度缩小率及随访3个月末的伤口治愈率与愈合时间为次要结局指标。结果 共脱落6例,试验组在负压治疗期间潮湿相关性皮肤损伤发生率、漏气报警和皮肤浸渍频次均少于对照组（均P<0.05）。试验组负压治疗14 d的伤口面积缩小率大于对照组（P<0.05）,深度缩小率两组接近（P>0.05）。随访期末试验组治愈率高于对照组（P<0.05）,两组愈合时间接近（P>0.05）。结论 两种皮肤保护法对预防潮湿相关性皮肤损伤均有一定效果,防漏膏保护法效果更优,在确保负压治疗顺利进行,改善伤口治疗效果,促进伤口愈合中发挥重要作用,适用于不同类型、不同部位的慢性伤口患者。     

经负压封闭装置给药与常规负压封闭引流技术治疗褥疮的临床研究

目的 对比经负压封闭系统给药与常规负压封闭引流两种技术在治疗褥疮上临床效果的差异.方法 2010年5月至2011年12月分别采用经负压封闭给药(给药组)技术治疗与常规封闭负压(VAC组)治疗49例褥疮患者(52处创面),随访时间6~12个月,详细观察两组治疗前后创面变化情况,记录并比较治疗2周前后创面愈合率、创面愈合时间、细菌培养阳性率及发生的并发症等资料.将临床观察及所收集的数据进行统计分析.结果 (1)给药组与VAC组治疗前后14 d创面愈合率分别为(12.8±1.9)%与(7.0±1.2)%,两组创面面积变化有统计学意义(t=13.453,P<0.001).给药组较常规负压封闭引流治疗更能促进创面愈合.(2)给药组与VAC组的愈合时间分别为(31.9±5.8)d与(57.9±17.1)d,两组创面愈合时间差异有统计学意义(t=-3.812,P<0.001).(3)给药组较VAC组相比并发症减少,差异有统计学意义(χ2=4.854,P=0.028).(4)给药组较VAC组细菌培养阳性率降低,差异有统计学意义(χ2=4.688,P=0.030).结论 经负压封闭系统给药技术治疗褥疮能提高创面愈合率,缩短愈合时间,减少并发症和细菌污染,较常规封闭负压治疗更为有效.     

Effects of mood on pain responses and pain tolerance: an experimental study in chronic back pain patients

Although chronic pain and depression commonly co-occur, causal relationships have yet to be established. A reciprocal relationship, with depression increasing pain and vice versa, is most frequently suggested, but experimental evidence is needed to validate such a view. The most straightforward approach would be a demonstration that increasing or decreasing depressed mood predictably modifies pain responses. The current experiment tested whether experimentally induced depressed and happy mood have differential effects on pain ratings and tolerance in 55 patients suffering from chronic back pain. Participants were randomly assigned to depressed, neutral (control) or elated mood induction conditions. They completed a physically passive baseline task prior to receiving mood induction, then a clinically relevant physically active task (holding a heavy bag) to elicit pain responses and tolerance. Measures were taken immediately after the baseline task and immediately after the mood induction to assess the changes in mood, pain ratings and tolerance before and after the experimental manipulation. Results indicate that the induction of depressed mood resulted in significantly higher pain ratings at rest and lower pain tolerance, whilst induced happy mood resulted in significantly lower pain ratings at rest and greater pain tolerance. Correlations between changes in mood on the one hand and changes in pain response and pain tolerance on the other hand were consistent with these findings. It is concluded that, in chronic back pain patients, experimentally induced negative mood increases self-reported pain and decreases tolerance for a pain-relevant task, with positive mood having the opposite effect.