2022 年第 11 期 第 17 卷

高渗盐水敷料联合红光在微创术后不愈合切口清创期的治疗应用

Application of hypertonic saline dressing combined with red light in the debridement period of non healing incision after minimally invasive surgery

作者：盖玉宁1孙柯1李亚楠1郑喜灿2

英文作者：Gai Yuning1 Sun Ke1 Li Yanan1 Zheng Xican2

单位：1中国人民解放军联勤保障部队第九八八医院烧伤整形普外科，郑州450007；2中国人民解放军联勤保障部队第九八八医院护理部，郑州450007

英文单位：1Department of Burn and Plastic Surgery and General Surgery No.988 Hospital of Joint Logistic Support Force of the Chinese People′s Liberation Army Zhengzhou 450007 China; 2Department of Nursing No.988 Hospital of Joint Logistic Support Force of the Chinese People′s Liberation Army Zhengzhou 450007 China

关键词：高渗盐水敷料；红光；切口不愈合；疼痛；清创期

英文关键词：Hypertonicsalinedressing;Redlight;Incisionnonhealing;Pain;Debridementperiod

• 摘要：

• 目的 探讨高渗盐水敷料联合红光在微创术后不愈合切口清创期的应用时机及效果。方法 入选2020年6月至2021年9月中国人民解放军联勤保障部队第九八八医院伤口治疗中心接诊的微创术后不愈合切口清创期患者26例，采用随机数字表法分为观察组和对照组，各13例。2组的伤口处理方法除了高渗盐水敷料的使用时机和存留时间不同，余均相同，且按照慢性伤口标准化处理进行干预。在常规消毒、清创处理后，观察组使用高渗盐水敷料覆盖创面并进行红光照射20 min，照射结束后即揭除高渗盐水敷料；对照组消毒、清创后红光照射20 min后再使用高渗盐水敷料覆盖创面并保留。2组的换药频率均为每3天换药1次。评估记录2组每次治疗清创后、红光照射过程中和换药后当天、第1天、第2天数字疼痛评分表评分，清创期清创次数和清创期到修复期所用时间。结果 2组每次治疗清创后、红光照射过程中数字疼痛评分表评分比较，差异均无统计学意义（均P＞0.05）；观察组换药后当天和换药后第1、2天疼痛评分均低于对照组［（2.85±0.15）分比（5.89±0.26）分、（2.83±0.13）分比（5.59±0.37）分、（1.68±0.38）分比（5.48±0.34）分］，差异均有统计学意义（均P＜0.001）。观察组清创期清创次数少于对照组［（3.0±1.6）次比（5.0±1.8）次］，清创期到修复期所用时间短于对照组［（6.4±1.7）d比（10.6±1.9）d］，差异均有统计学意义（均P=0.001）。结论 高渗盐水敷料联合红光照射治疗微创术后不愈合切口清创期的推荐使用方法是清创后覆盖高渗盐水敷料进行红光照射20 min后揭除，其综合治疗效果好于红光照射后再持续使用高渗盐水敷料。

• Objective To explore the application opportunity and effect of hypertonic saline dressing combined with red light in the debridement period of non healing incision after minimally invasive surgery. Methods From June 2020 to September 2021, 26 patients with non healing incision in the debridement period after minimally invasive surgery admitted to the Wound Treatment Center, No.988 Hospital of Joint Logistic Support Force of the Chinese People′s Liberation Army were selected. They were randomly divided into the observation group and the control group, with 13 cases in each group. The treatment of wound in the two groups were the same according to the standardized treatment of chronic wounds except that the use time and duration of hypertonic saline dressing were different. After routine disinfection and debridement, the observation group used hypertonic saline dressing to cover the wound and irradiated with red light for 20 min. After irradiation, the hypertonic saline dressing was removed immediately. In the control group, after disinfection and debridement, the wound was covered with hypertonic saline dressing and retained after red light irradiation for 20 min. The dressing change frequency of the two groups was every 3 d. The scores of the two groups each treatment on the digital pain scale after debridement, during red light irradiation and on the day, day 1 and day 2 after dressing change, times of debridements and the time from debridement to repair were recorded. Results There were no significant differences in the scores of digital pain scale between the two groups after debridement and during red light irradiation (both P＞0.05). The scores of digital pain scale in the observation group on the day , day 1 and day 2 after dressing change were lower than those in the control group［（2.85±0.15） vs （5.89±0.26）, （2.83±0.13） vs （5.59±0.37）, （1.68±0.38） vs （5.48±0.34）］(all P＜0.001). The time of debridement in the observation group was less than that in the control group［（3.0±1.6）times vs （5.0±1.8）times］, and the time from debridement to repair was shorter than that in the control group［（6.4±1.7）d vs （10.6±1.9）d］(both P=0.001). Conclusions The recommended use of hypertonic saline dressing combined with red light irradiation in the debridement period of non healing incision after minimally invasive surgery is to cover the hypertonic saline dressing after debridement and remove it after red light irradiation for 20 min. Its comprehensive treatment effect is better than that of maintaining hypertonic saline dressing after red light irradiation.