Đánh giá kết quả ứng dụng liệu pháp hút áp lực âm chăm sóc khuyết hổng phần mềm tại Bệnh viện Hữu nghị Việt Tiệp Hải Phòng

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Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Khoa học Điều dưỡng, 2020

Mô tả vật lý: tr.96

Bộ sưu tập: Báo, Tạp chí

ID: 322254

Thêm vào giỏ Liên kết toàn văn

Mục tiêu: Mô tả đặc điểm lâm sàng và đánh giá kết quả chăm sóc vết thương khuyết hổng phần mềm được điều trị bằng liệu pháp hút áp lực âm tại Bệnh viện Hữu Nghị Việt Tiệp Hải Phòng. Đối tượng và phương pháp nghiên cứu: Nghiên cứu tiến cứu, quan sát mô tả bệnh chứng trên 312 người bệnh được áp dụng liệu pháp hút áp lực âm tại Bệnh viện Hữu Nghị Việt Tiệp Hải Phòng từ năm 2014 đến năm 2018. Kỹ thuật đặt hút áp lực âm gồm 5 bước, cài đặt chế độ hút là 18-20 Kpa (135-150 mmHg) hoặc 16-18 Kpa (120-135 mmHg). Đánh giá kết quả hút áp lực âm bằng đánh giá mức độ đau, thời gian thay băng, kích thước vết thương, mức độ tiết dịch, sự phát triển của tổ chức hạt tại vết thương và thời gian hút áp lực âm. Kết quả: Nguyên nhân khuyết hổng phần mềm thường gặp nhất là loét do tỳ đè chiếm tỷ lệ 64,74%. Vị trí thường gặp nhất là vùng cùng cụt 46,47%. khuyết hổng phần mềm độ IV chiếm tỷ lệ cao nhất 51,6%, diện tích khuyết hổng phần mềm từ 50-100 cm2 chiếm tỷ lệ cao nhất với 56,73%. Tổn thương phổ biến nhất là khuyết hổng phần mềm mạn tính 51,7%. Đánh giá người bệnh sau can thiệp cho thấy: Mức độ đau (theo thang điểm VAS) của người bệnh giảm. Diện tích vết thương thu nhỏ hơn
lượng dịch tiết tại chỗ còn lại rất ít, chỉ còn đủ ẩm tạo môi trường liền thương. Tổ chức hạt phát triển tại khuyết hổng phần mềm nhanh, tổ chức hạt đỏ, sạch, phủ kín toàn bộ bề mặt khuyết hổng phần mềm. Thời gian thay băng được rút ngắn hơn. Kết luận: Liệu pháp hút áp lực âm có nhiều ưu điểm hơn hẳn so với kỹ thuật chăm sóc vết thương thông thường. Dịch viêm được loại bỏ, tuần hoàn tại chỗ được tăng cường, vết thương sạch, tổ chức hạt nhanh mọc, kích thước vết thương được thu nhở, người bệnh đỡ đau đớn, thời gian thay băng được rút ngắn nên thuận lợi cho quá trình điều trị.Objective: Describe clinical features and evaluate the nursing care outcome of muscle loss injury using negative pressure therapy at Viet Tiep hospital, Hai Phong province. Method: Progressive research, observational and descriptive studies on 312 patients who applied negative pressure therapy at Hai Phong Viet Tiep Hospital from 2014 to 2018. The NPT conswasts of 5 steps, suction mode at 18-20 Kpa (135-150 mmHg) or 16-18 Kpa (120-135 mmHg). Evaluate the results of negative pressure therapy by assessing patient pain, dressing change time, wound size, level of exudate at wound, growth of granulation and NPT time. Results: The most common cause of muscle loss was pressure ulcers, accounting for 64.74%. The most common position of muscle loss was the coccyx region with 46.47%. Muscle loss level IV accounts for the highest rate with 51.6%, the area of muscle loss from 50-100 cm2 accounts for the highest rate with 56.73%. Chronic wound was the most common wound type with 51.7%. The after-therapy assessment showed that: The pain level (according to the VAS scale) of the patient decreased
the local exudate remains very little, just enough moisture to create a healing environment. Granulation tissues grow quickly. The wound bed was red and clean. Dressing change time in negative pressure therapy was shorter. Conclusion: The study showed that the negative pressure therapy brought in many advantages over conventional wound care techniques. Inflammatory fluid was eliminated, local circulation was strengthened, the wound was clean, the granulation tissues growedp, the size of the wound was reduced, the patient was less painful, the time to change the dressing was shortened, which are favorable for treatment.

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