慢性傷口之物理治療

Physical Therapy for Chronic Wounds

鐘秀慧(Hsiu-Hui Chung) ； 胡名霞(Ming-Hsia Hu)

《中華民國物理治療學會雜誌》 22卷1期 (1997/01) Pp. 55-67

https://doi.org/10.29616/JPTAROC.199701.0006

摘要

慢性傷口，尤其是壓瘡及下肢血管性傷口，是老年人及慢性病人常見的問題。傳統的物理治療處理方式強調定時翻身、恰當的擺位、以及使用紫外線照射等療法以預防傷口發生及促進組織癒合。此外，水療、電療、及低能雷射亦為可選用之物理治療方式。例如國內曾有個案報告指出低能雷射對於壓瘡傷口的癒合有相當好的療效。雖然物理治療對於慢性傷口的處理方式相當多，而且許多文獻顯示有相當好的療效，然而國內臨床上因慢性傷口，尤其是下肢血管性傷口，而照會物理治療的病人卻並不多。反之，國外的物理治療師對於患有慢性傷口的病人卻扮演相當積極的治療角色。本文將討論壓瘡及下肢血管性傷口之物理治療評估與處置方法，尤其是對於國內較不熟悉之評估項目與治療項目做比較仔細的介紹。例如壓瘡的分級法、傷口大小的標準測量法、傷口狀態的記錄法、踝臂血壓比值（ankle-brachial index，簡稱ABI）等評估法，以及水療、電療、超音波、壓迫療法(compression therapy)的施行方法，均有詳細的介紹。希望藉此討論可以增進國內物理治療界對參與慢性傷口治療更完整的認識。

關鍵字

壓瘡 ； 血管性慢性傷口 ； 物理治療

並列摘要

Chronic wounds, especially pressure ulcers and vascular leg ulcers, are commonly seen in older population and long-term care patients. A multidisciplinary team approach is required to manage chronic wounds. The team may include doctors, physical therapists, occupational therapists, speech pathologists, nutritionists and nurses. With increasing clinical studies supporting positive effects of physical therapy in wound care, physical therapists are increasing their involvement in the prevention and treatment of chronic wounds.
Physical therapists can assist in improving patient mobility, positioning the patient in bed and chair, and providing patients with appropriate support surfaces and pressure-relieving devices. Furthermore, a number of physical therapy modalities, such as whirlpool, electrical stimulation, ultrasound, low-energy laser and compression therapy, can be applied to the patient to enhance wound healing.
The management of chronic wounds are a relatively new field for the therapists in Taiwan, and not many patients with chronic wounds are referred to physical therapy. The purpose of this paper is to review the etiology, risk factor, assessment, treatment, and prevention methods of pressure ulcers and vascular leg ulcers. In addition, the treatment indications, contraindications, suggested settings and treatment procedures for whirlpool, electrical stimulation, ultrasound, and compression therapy used in chronic wound care are presented in detail.

並列關鍵字

Pressure ulcer ； Vascular leg ulcers ； Physical therapy