張曉玲

[摘要]目的：探討全身浸浴護(hù)理在預(yù)防大面積深度燒傷后期殘余創(chuàng)面感染的臨床應(yīng)用效果。方法：選取2013年9月-2016年4月筆者醫(yī)院收治的大面積深度燒傷患者120例為研究對象，按照隨機(jī)數(shù)字表法分為觀察組和對照組，每組60例。對照組給予常規(guī)護(hù)理，觀察組在常規(guī)護(hù)理的基礎(chǔ)上加用全身浸浴護(hù)理。比較兩組患者護(hù)理有效率、護(hù)理干預(yù)前后疼痛評分及創(chuàng)面愈合情況。結(jié)果：觀察組護(hù)理有效率為93.33%（56/60），高于對照組的60.00%（36/60），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。護(hù)理干預(yù)后，觀察組疼痛評分、創(chuàng)面愈合時間及生活活動能力評分均優(yōu)于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。護(hù)理干預(yù)后，兩組IL-4、IL-10水平均低于護(hù)理干預(yù)前，且觀察組低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：全身浸浴護(hù)理有助于降低大面積深度燒傷后期殘余創(chuàng)面感染情況，降低患者創(chuàng)面疼痛感，促進(jìn)預(yù)后恢復(fù)及生活質(zhì)量的提高，值得在臨床中應(yīng)用推廣。

[關(guān)鍵詞]全身浸浴護(hù)理；大面積深度燒傷；殘余創(chuàng)面；創(chuàng)面感染

[中圖分類號]R47 [文獻(xiàn)標(biāo)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(yán)重者傷及皮下組織或黏膜[1]。一旦燒傷發(fā)生，患者極易出現(xiàn)創(chuàng)面感染等臨床癥狀，時刻威脅著患者生命，同時影響預(yù)后恢復(fù)效果[2-4]。若患者為大面積深度燒傷，臨床上大多采用手術(shù)治療的方式，通過手術(shù)清除壞死皮膚及黏膜組織，術(shù)后立刻覆蓋創(chuàng)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(shù)修復(fù)創(chuàng)面的成功率，并降低術(shù)后感染的發(fā)生，在治療的同時給予相應(yīng)的護(hù)理措施顯得尤為重要。近年來，全身浸浴護(hù)理模式在臨床上的推廣應(yīng)用取得了較好的效果?；诖?，本研究對此種護(hù)理方法在預(yù)防大面積深度燒傷后期殘余創(chuàng)面感染的應(yīng)用展開分析?，F(xiàn)報(bào)道如下。