全身浸浴護理在預防大面積深度燒傷后期殘余創面感染的應用研究

張曉玲

[摘要]目的：探討全身浸浴護理在預防大面積深度燒傷后期殘余創面感染的臨床應用效果。方法：選取2013年9月-2016年4月筆者醫院收治的大面積深度燒傷患者120例為研究對象，按照隨機數字表法分為觀察組和對照組，每組60例。對照組給予常規護理，觀察組在常規護理的基礎上加用全身浸浴護理。比較兩組患者護理有效率、護理干預前后疼痛評分及創面愈合情況。結果：觀察組護理有效率為93.33%（56/60），高于對照組的60.00%（36/60），差異有統計學意義（P<0.05）。護理干預后，觀察組疼痛評分、創面愈合時間及生活活動能力評分均優于對照組，差異有統計學意義（P<0.05）。護理干預后，兩組IL-4、IL-10水平均低于護理干預前，且觀察組低于對照組，差異有統計學意義（P<0.05）。結論：全身浸浴護理有助于降低大面積深度燒傷后期殘余創面感染情況，降低患者創面疼痛感，促進預后恢復及生活質量的提高，值得在臨床中應用推廣。

[關鍵詞]全身浸浴護理；大面積深度燒傷；殘余創面；創面感染

[中圖分類號]R47 [文獻標志碼]B [文章編號]1008-6455（2018）07-0132-03

Abstract： Objective To study the clinical effect of whole body bath care in preventing residual wound infection in the late stage of deep burn. Methods 120 cases of patients with extensive burns admitted in our hospital from September 2013 to April 2016 were selected as the subjects. All patients were divided into the control group and the observation group according to the random number table method， 60 cases in each group. The patients in the control group were given routine care to prevent residual wound infection in the late stage of deep burn， and the patients in the observation group were treated with systemic bath care on a routine basis. The nursing effectiveness， before and after treatment of pain scores and wound healing were compared between the two groups. Results The effective rate of nursing in the observation group was 93.33% （56/60）， which was higher than that in the control group （60.00%，36/60）， and the difference was statistically significant（P<0.05）. After nursing intervention， the pain score， wound healing time and life activity ability score of the observation group were better than those of the control group（P<0.05）. After nursing intervention， the levels of IL-4 and IL-10 in the two groups were lower than those before nursing intervention， and the observation group was lower than that of the control group（P<0.05）. Conclusion Whole body bathing can help reduce the incidence of residual wound infection in the late post-burn stage， reduce the pain of the patient's wound， promote the recovery of the prognosis and improve the quality of life in the clinical application worthy of promotion.

Key words： whole body bath care； large area deep burn； residual wound； wound infection

燒傷是臨床上常見的外科疾病，指在熱液、蒸汽、高溫氣體或火焰等因素下對人體組織造成的損害，主要是對患者的皮膚及黏膜組織造成傷害，嚴重者傷及皮下組織或黏膜[1]。一旦燒傷發生，患者極易出現創面感染等臨床癥狀，時刻威脅著患者生命，同時影響預后恢復效果[2-4]。若患者為大面積深度燒傷，臨床上大多采用手術治療的方式，通過手術清除壞死皮膚及黏膜組織，術后立刻覆蓋創面，可較好地避免因過多流失體液及能量造成感染[5]。因此，為了提高手術修復創面的成功率，并降低術后感染的發生，在治療的同時給予相應的護理措施顯得尤為重要。近年來，全身浸浴護理模式在臨床上的推廣應用取得了較好的效果?；诖?，本研究對此種護理方法在預防大面積深度燒傷后期殘余創面感染的應用展開分析?，F報道如下。