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摘要 介绍了次氯酸溶液的发展史、杀菌机制、特点、与其他伤口清洁消毒剂的比较、使用方法以及当前研究的不足,旨在为次氯酸溶液在伤口治疗、护理中的应用提供依据。
关键词 次氯酸溶液;伤口;感染;细菌生物膜;临床应用;综述
摘 要 目的了解城市医共体内社区护士开展“互联网+伤口护理服务”意愿及需求,为完善“互联网+伤口护理服务”模式提供参考。方法自拟访谈提纲对城市医共体内7个社区卫生服务中心的11名社区护士进行一对一的深入访谈,采用Colaizzi现象学研究法分析资料、提炼主题。结果提炼出4个主题:1)有较强的参与“互联网+伤口护理服务”意愿。(2)健全相关法律法规的需求。(3)控制护理服务风险和保障执业安全的需求。(4)完善相关配套制度和创新服务举措的需求。结论城市医共体内社区护士对“互联网+伤口护理服务”的参与意愿较强,健全法律法规、降低服务风险、完善配套制度及创新服务举措是当前主要需求。相关政府管理部门应尽快推进法律法规、制度流程、风险防范及服务新举措的建设和完善,以促进“互联网+伤口护理服务”良性发展。
关键词 社区护士 ;伤口护理;互联网+护理;质性研究
Abstract: Bee venom (BV), also known as api-toxin, is widely used in the treatment of different inflammatory diseases such as rheumatoid arthritis or multiple sclerosis. It is also known that BV can improve the wound healing process. BV plays a crucial role in the modulation of the different phases of wound repair. It possesses anti-inflammatory, antioxidant, antifungal, antiviral, antimicrobial and analgesic properties, all of which have a positive impact on the wound healing process. The mentioned process consists of four phases, i.e., hemostasis, inflammation, proliferation and remodeling. The impaired wound healing process constitutes a significant problem especially in diabetic patients, due to hypoxia state. It had been found that BV accelerated the wound healing in diabetic patients as well as in laboratory animals by impairing the caspase-3, caspase-8 and caspase-9 activity. Moreover, the activity of BV in wound healing is associated with regulating the expression of transforming growth factor (TGF-β1), vascular endothelial growth factor and increased collagen type I. BV stimulates the proliferation and migration of human epidermal keratinocytes and fibroblasts. In combination with polyvinyl alcohol and chitosan, BV significantly accelerates the wound healing process, increasing the hydroxyproline and glutathione and lowering the IL-6 level in wound tissues. The effect of BV on the wounds has been proved by numerous studies, which revealed that BV in the wound healing process brings about a curative effect and could be applied as a new potential treatment for wound repair. However, therapy with bee venom may induce allergic reactions, so it is necessary to assess the existence of the patient’s hypersensitivity to apitoxin before treatment.
Keywords: bee venom; wound healing; biological properties; molecular mechanism.
Abstract: Macrophages play a prominent role in wound healing. In the early stages, they promote inflflammation and remove pathogens, wound debris, and cells that have apoptosed. Later in the repair process, they dampen inflflammation and secrete factors that regulate the proliferation, differentiation,and migration of keratinocytes, fifibroblasts, and endothelial cells, leading to neovascularisation and wound closure. The macrophages that coordinate this repair process are complex: they originate from different sources and have distinct phenotypes with diverse functions that act at various times in the repair process. Macrophages in individuals with diabetes are altered, displaying hyperresponsiveness to inflflammatory stimulants and increased secretion of pro-inflflammatory cytokines. They also have a reduced ability to phagocytose pathogens and efferocytose cells that have undergone apoptosis. This leads to a reduced capacity to remove pathogens and, as efferocytosis is a trigger for their phenotypic switch, it reduces the number of M2 reparative macrophages in the wound. This can lead to diabetic foot ulcers (DFUs) forming and contributes to their increased risk of not healing and becoming infected, and potentially, amputation. Understanding macrophage dysregulation in DFUs and how these cells might be altered, along with the associated inflflammation, will ultimately allow for better therapies that might complement current treatment and increase DFU’s healing rates.
Keywords: macrophage; inflflammation; diabetic foot ulcer; chronic wound; efferocytosis; phenotype; infection.