Selkowitz David M, Cameron Michelle H, Mainzer Aleah, Wolfe Ron
Department of Physical Therapy Education, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA.
Ostomy Wound Manage. 2002 Apr;48(4):40-4, 46-50.
Therapeutic ultrasound is used clinically to enhance healing of pressure ulcers. Limited clinical research is available and no consensus exists regarding the efficacy of ultrasound for treating pressure ulcers, particularly full-thickness pressure ulcers, in the elderly. To assess the efficacy of pulsed low-intensity ultrasound on wound healing, a double-blind, single-case, baseline-AB study was conducted. The participant, a patient in a skilled nursing facility, was a 75-year-old woman with a Stage III pressure ulcer over the coccyx. Pulsed low-intensity ultrasound was compared to placebo ultrasound. After the 1-week baseline period, each ultrasound treatment was administered 5 days a week for two consecutive weeks. Throughout the baseline and ultrasound treatment periods, the patient additionally received the standard wound care treatment program at the facility. The rate of wound surface area reduction was used as the measure of wound healing. Healing was significantly faster (P = 0.001) during the pulsed low-intensity ultrasound period (34.0 mm2/day) compared to the placebo ultrasound period (12.6 mm2/day), but was significantly faster (P = 0.001) during the baseline period (50.8 mm2/day) compared to the pulsed low-intensity ultrasound period. Healing in this patient was faster than rates noted in the literature under similar conditions. The precise effect of either ultrasound intervention in this study could not be determined. Neither pulsed low-intensity ultrasound nor placebo ultrasound likely had an appreciable effect on healing of this patient's pressure ulcer beyond that of the standard-care protocol.
治疗性超声在临床上用于促进压疮的愈合。现有的临床研究有限，对于超声治疗老年人压疮，尤其是全层压疮的疗效尚无共识。为了评估脉冲低强度超声对伤口愈合的疗效，进行了一项双盲、单病例、基线-AB研究。参与者是一名熟练护理机构的患者，为一名75岁女性，尾骨处有III期压疮。将脉冲低强度超声与安慰剂超声进行比较。在为期1周的基线期后，每种超声治疗每周进行5天，连续进行两周。在整个基线期和超声治疗期，患者在该机构还接受了标准的伤口护理治疗方案。伤口表面积减少率用作伤口愈合的指标。与安慰剂超声期（12.6平方毫米/天）相比，脉冲低强度超声期（34.0平方毫米/天）的愈合明显更快（P = 0.001），但与脉冲低强度超声期相比，基线期（50.8平方毫米/天）的愈合明显更快（P = 0.001）。该患者的愈合速度比文献中在类似条件下记录的速度更快。本研究中任何一种超声干预的确切效果无法确定。与标准护理方案相比，脉冲低强度超声和安慰剂超声对该患者压疮的愈合可能均未产生明显影响。
