The application effect of moist burn ointment combined with hyperbaric oxygen therapy in the repair of stage 3-4 pressure injury wounds
湿润烧伤膏联合高压氧治疗在3-4期压力性损伤创面修复的应用效果

摘要

目的 探讨湿润烧伤膏联合高压氧治疗在3-4期压力性损伤创面修复中的应用效果。方法 选取2024年2月至2025年2月期间我院收治的3-4期压力性损伤创面修复患者90例作为研究对象。采用随机数字表法将患者分为对照组及观察组，每组45例。对照组患者年龄范围为43-78岁，平均年龄（55.43±5.20）岁；观察组患者年龄范围为45-80岁，平均年龄（60.51±5.57）岁。两组患者一般资料（年龄、性别、压力性损伤创面等）比较，差异无统计学意义（P>0.05），具有可比性。对照组给予生理盐水清洗创面，局部采用碘伏消毒，涂抹湿润烧伤膏（规格：40g/支，用量：0.5-1.0g/cm²，每日2次）。观察组在对照组基础上联合高压氧治疗方法，具体为：在高压氧舱内，患者佩戴面罩吸入纯氧，压力为0.2MPa，吸氧时间为60分钟，每日1次，10次/疗程，疗程间隔7-10天。比较两组患者压力性损伤创面修复情况，包括压力性损伤愈合计分量表（Pressure Ulcer Scale for Healing， PUSH）评分、创面愈合率、组织病理学分析、血氧饱和度、患者治疗满意度等指标。结果 经过治疗，观察组压力性损伤患者PUSH各维度评分均高于对照组，具体数据为创面治愈总体有效率：观察组治疗后30天创面治愈率为（97.78）%，对照组为（75.56）%，差异有统计学意义（P<0.01）。组织病理学分析显示，观察组治疗后表皮结构、真皮-表皮邻接和微水疱、胶原束和皮肤结构、表皮再生、粒细胞浸润等指标均优于对照组。血氧饱和度及动脉血氧分压总体平均值方面，对照组动脉血氧饱和度92%、静脉血氧饱和度65%，动脉血氧分压83mmHg；观察组动脉血氧饱和度98%、静脉血氧饱和度85%，动脉血氧分压95mmHg。观察组显著高于对照组。患者治疗满意度方面，观察组患者治疗满意度总体平均评分为9.25分，对照组为8.5分。以上差异具有统计学意义（P<0.05）。结论 湿润烧伤膏联合高压氧治疗与单纯湿润烧伤膏治疗相比，联合疗法显著缩短愈合时间（14天vs26天），显示湿润烧伤膏的湿润环境与高压氧联合治疗存在叠加效应，同时湿润烧伤膏联合高压氧治疗无侵袭性，不良反应少，助力患者加速康复进程，缩短住院时间，同时降低并发症的发生风险并减少治疗成本。

Abstract

Objective To explore the application effect of MEBO combined with hyperbaric oxygen therapy in the repair of 3-4 stage pressure injury wounds.
Methods A total of 90 patients with 3-4 stage pressure injury wounds admitted to our hospital from February 2024 to February 2025 were selected as the study subjects. The patients were divided into a control group and an observation group using a random number table method, with 45 cases in each group. The age range of patients in the control group was 43-78 years, with an average age of (55.43±5.20) years; the age range of patients in the observation group was 45-80 years, with an average age of (60.51±5.57) years. There were no statistically significant differences in general information (age, gender, pressure injury wounds, etc.) between the two groups (P>0.05), making them comparable. The control group was treated with physiological saline to clean the wound surface, locally disinfected with iodophor, and applied with MEBO (specification: 40g/tube, dosage: 0.5-1.0g/cm², twice daily). The observation group received hyperbaric oxygen therapy in addition to the control group's treatment. Specifically, patients wore face masks to inhale pure oxygen in a hyperbaric oxygen chamber at a pressure of 0.2MPa for 60 minutes, once daily, with 10 sessions per course, and a course interval of 7-10 days. The repair of pressure ulcer wounds in the two groups was compared, including indicators such as the Pressure Ulcer Scale for Healing (PUSH) score, wound healing rate, histopathological analysis, blood oxygen saturation, and patient satisfaction with treatment.
Results After treatment, the PUSH scores of patients with pressure ulcers in the observation group were higher than those in the control group. Specifically, the overall effective rate of wound healing was (97.78) % in the observation group and (75.56) % in the control group 30 days after treatment, with a statistically significant difference (P<0.01). Histopathological analysis showed that after treatment, indicators such as epidermal structure, dermal-epidermal junction and microvesicles, collagen bundles and skin structure, epidermal regeneration, and granulocyte infiltration were superior in the observation group compared to the control group. In terms of overall average values of blood oxygen saturation and arterial partial pressure of oxygen, the control group had an arterial blood oxygen saturation of 92%, venous blood oxygen saturation of 65%, and an arterial partial pressure of oxygen of 83mmHg; the observation group had an arterial blood oxygen saturation of 98%, venous blood oxygen saturation of 85%, and an arterial partial pressure of oxygen of 95mmHg. The observation group significantly outperformed the control group. In terms of patient satisfaction with treatment, the overall average score for the observation group was 9.25, compared to 8.5 for the control group. These differences were statistically significant (P<0.05).
Conclusion   Compared with MEBO treatment alone, MEBO combined with hyperbaric oxygen therapy significantly shortened the healing time (14 days vs 26 days), indicating a synergistic effect of the moist environment provided by MEBO and hyperbaric oxygen therapy. Additionally, MEBO combined with hyperbaric oxygen therapy is non-invasive, has fewer adverse reactions, accelerates the recovery process of patients, shortens hospitalization time, reduces the risk of complications, and reduces treatment costs.