Relationship between typical wound healing process based on morphology in elderly and nursing management

目的：分析老年患者压疮形态及影响压疮发展的因素，阐明难治性压疮形态分期与护理管理的关系。对象：对象为115例（男37例，女78例）住院患者，主要以心血管疾病为主。平均年龄和标准差为81.4± 7.0泪，所有患者均知情同意进行摄影检查。按溃疡部位、溃疡分期及形态学对标准治愈的压疮进行分类。2.超过1年无法治愈的压疮被归类为相同的方式。3.分析压疮治愈过程与护理管理的关系。根据NPIJAP分类法对压疮深度进行分期。结果：1标准疗程治愈的压疮以骶部为主 ...更多信息 (44患者）。固化时间随深度的增加而增加。在II期和IV期检测到囊袋的形成，仅在IV期发现所有边缘周围的囊袋。Ⅰ期根据发红程度分为2个亚组，Ⅱ期根据坏死组织的存在分为2个亚组，Ⅱ期根据囊袋的形成分为3个亚组，Ⅳ期根据坏死组织的附着情况和囊袋的形态分为5个亚组。据估计，肉芽肿增生不充分、厚度不足、浸润、酮症过多和溃疡边缘张力不足是导致治愈时间延长的原因。根据溃疡上皮化程度、囊袋愈合阶段和肉芽肿增生程度，将溃疡分为6个亚组.通过对压疮治愈过程与护理管理关系的分析，认为护理管理的引入，包括加压、防滑、清洁、体位的改变等，促进了压疮的治愈。骶骨部压疮伴收缩者治愈期有延长的趋势，据此提出了一种新的压疮治愈期分类方法。利用此方法，将有可能实现治愈的估计和有效的护理管理。少

Purpose: We analyzed the morphology of pressure ulcer and the factor influencing the development of pressure ulcer in elderly patients, to clarify the relationship between morphological stage of incurable pressure ulcer and the care management.Objects: Objects were 115 patients (male 37, female 78) who admitted, mainly by cardiovascular diseases in hospital. Mean age and SD was 81.4± 7.0 tear and the informed consent for photographic examination was taken from all patients.Methods: 1. The pressure ulcered cured in standard, course were classified by the region, the stages of ulcer, and morphology. 2. The pressure ulcers which were incurable for more than one year were classified as same manner. 3. The relationship between the curable course of the pressure ulcer and the care management was analyzed. Staging of depth of pressure ulcers was classified by NPIJAP classification. Result: 1 Main region seen in the pressure ulcers that were normally cured in standard course was sacral region … More (44 patients). Duration for cure was increased with stage of depth. Formation of the pocket was detected in stage II and IV and the pocket surrounding all margins was only found in stage IV. Stage I was categorized into two subgroup by the degree of redness, stage II into two by the presence of necrotic tissue, stage II into three by the presence of pocket formation, and stage IV into five by the condition of attachment of the necrotic tissue and morphology of pocket.The 13 pressure ulcers incurable within one year were found at sacrum, coccyx, major trochanter, and ischial tuberosities. The etiology of prolonged for cure was estimated to be an in sufficient proliferation of granuloma, thickness, maceration, hyperketoratosis and tension at ulcer margin. The ulcer was morphologically categorized into six subgroups by the epithelization, the cure stage of pocket, and the proliferation of granuloma.3. From the analysis of the relationship between curable course of the pressure ulcer and care management, the introduction of care management with improvement of pressure, slipping, cleanness, and the change of position accelerated the cure of pressure ulcer. The curative period of pressure ulcer at sacrum with contraction was tendency to be long.From these results, a new classification in stage of curative pressure ulcer was found by the categorization of pressure ulcer in the curative stage. Using this method, it will be possible to achieve the estimation of cure and the effective care management. Less