一个接受负压伤口治疗的糖尿病患者胫腓骨骨折术后钢板外露的护理管理：病例报道
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何茜
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重庆医科大学附属第二医院，重庆，400000
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摘要: 目的 探讨负压伤口治疗（NPWT）在糖尿病患者胫腓骨骨折术后钢板外露合并感染伤口中的护理管理效果，为类似复杂伤口的临床处理提供参考。方法 报告一例 46 岁女性糖尿病患者，因严重多发伤行胫腓骨内固定术后出现钢板外露伴感染。护理措施包括强化血糖控制、局部清创、NPWT 应用、抗生素治疗及营养支持。NPWT 每 5 天更换一次，后期联合成纤维细胞生长因子（贝复济）和表皮生长因子促进愈合。结果 经过 67 天的综合治疗，患者伤口逐渐愈合，感染得到控制，血糖、血红蛋白等指标恢复正常，避免了内固定物取出，最终伤口完全愈合。结论 NPWT 结合多学科协作的护理策略能有效促进糖尿病患者术后复杂伤口的愈合，尤其适用于钢板外露伴感染的情况，具有临床推广价值
关健词：钢板外露；糖尿病；负压伤口治疗；生物活性制剂；护理管理
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Nursing management of plate exposure after tibiofibular fracture surgery in a diabetes patient receiving negative pressure wound
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Qian He
Second Affiliated Hospital of Chongqing Medical University, Chongqing 400000
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Abstract: Objective To explore the effect of negative pressure wound treatment (NPWT) on nursing management of infected wounds caused by plate exposure after tibial and fibular fracture surgery in diabetes patients, and to provide reference for clinical treatment of similar complex wounds.Methods A 46 year old female patient with diabetes was reported, who suffered from plate exposure and infection after internal fixation of tibia and fibula due to severe multiple injuries. Nursing measures include strengthening blood glucose control, local debridement, application of NPWT, antibiotic treatment, and nutritional support. NPWT should be replaced every 5 days, and later combined with fibroblast growth factor (Beifuji) and epidermal growth factor to promote healing. Results After 67 days of comprehensive treatment, the patient's wound gradually healed, the infection was controlled, blood sugar, hemoglobin and other indicators returned to normal, avoiding the removal of internal fixation, and ultimately the wound fully healed.Conclusion The nursing strategy of NPWT combined with multidisciplinary cooperation can effectively promote the healing of complicated wounds in patients with diabetes after surgery, especially in the case of plate exposure with infection, which has clinical value
Keywords : steel plate exposed, diabetes negative pressure wound treatment, biological active agents, nursing management
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