艾灸燙傷乳頭致難愈性潰瘍一例的治療與思考課件

1、艾灸燙傷乳頭致難愈性潰瘍一例的治療與思考 Ulcer on nipple caused by moxibustion scald :a case report 解放軍總醫(yī)院第一附屬醫(yī)院創(chuàng)口修復(fù)中心 匯報(bào)人 張海軍 郝岱峰 馮 光 褚萬(wàn)立 李 濤 張媛媛李善友 趙景峰 張新建 陳澤群 趙 帆 一、背景資料(Background)二、病例資料(Case)三、治療過(guò)程(Treatment) 四、體會(huì)思考(Discussion) 一、背景資料(Background)艾灸是中國(guó)最古老的醫(yī)術(shù)之一，屬于物理療法，點(diǎn)燃用艾葉制成的艾炷、艾條為主，熏烤人體的穴位以達(dá)到保健治病的一種自然療法。Moxibustio

2、n is one of Chinas oldest medical skill, belong to physical therapy, lit moxa stick which made with artemisiae argyi , smoked human body points, a natural therapy for health care.一、背景資料(Background)二、病例資料(Case)三、治療過(guò)程(Treatment) 四、體會(huì)思考(Discussion) 二、病例資料惠X，女，53歲，主訴“左側(cè)乳頭艾灸后慢性潰瘍1年”?；颊?年前在家中自行艾灸乳中穴時(shí)不慎燙傷乳

3、頭，在當(dāng)?shù)蒯t(yī)院換藥未見(jiàn)明顯好轉(zhuǎn)，為求進(jìn)一步治療，于我科門(mén)診收治入院。既往有乳腺增生病史，無(wú)糖尿病等其它疾病病史。Hui X,female, 53 years old, complained chronic ulcer on left nipple after moxibustion for 1 year. One year ago, the patient suffered burn accidentally while taking moxibustion point on nipple at home , the wound was no significantly improvement

4、 after dressing for a long time in the local hospitals, for further treatment, she was admitted in our department. Previous history : breast hyperplasia.二、病例資料入院?？撇轶w：左側(cè)乳頭正中可見(jiàn)潰瘍創(chuàng)面，局部呈凹陷狀，可見(jiàn)少量滲出液，為淡黃色無(wú)血性液體，乳頭紅腫明顯，疼痛敏感。創(chuàng)面無(wú)明顯異味，左腋下未觸及腫大淋巴結(jié)。伴明顯焦慮狀態(tài)：女性更年期，治療周期長(zhǎng)。Special examination: ulcer wound was located

5、 on the middle of the left nipple, a concave shape, some effusion of a pale yellow liquid without bloody, nipple was swelling,got pain sensitivity. There was no significant odor in the wound surface, and the enlarged lymph nodes were not palpable in the left arm.Anxiety state: female menopause, trea

6、tment last for a long time .二、病例資料血液檢查未見(jiàn)明顯異常。乳腺超聲及鉬靶:雙側(cè)乳腺增生；多發(fā)囊性結(jié)節(jié)。創(chuàng)面細(xì)菌培養(yǎng)：無(wú)菌生長(zhǎng)。There was no obvious abnormality in blood examination.Breast ultrasound and X-ray: bilateral breast hyperplasia; multiple cystic nodules.Bacterial culture of wound: aseptic growth.三、治療過(guò)程相關(guān)科室會(huì)診普外科會(huì)診：排除乳腺癌；心理科會(huì)診：解除焦慮狀態(tài)； Rel

7、ated department consultationDepartment of general surgery consultation: excluding breast cancerPsychological consultation: relaxing of the state of anxiety 三、治療過(guò)程負(fù)壓封閉引流：乳頭較為敏感，經(jīng)5天治療后無(wú)明顯改善，拒絕再行負(fù)壓。經(jīng)2月余治療后無(wú)明顯好轉(zhuǎn)，建議患者手術(shù)切除，因部位特殊，拒絕手術(shù)；Negative pressure drainage: nipple is more sensitive to pain, after 5 da

8、ys of treatment, no significant improvement, refused to negative pressure. With no significant improvement after treatment of more than 2 months ,because of the special point, refused surgery;三、治療過(guò)程中醫(yī)科會(huì)診辯證：氣虛血瘀（由于氣虛，推動(dòng)、溫煦血液作用減弱，導(dǎo)致血液循環(huán)遲緩不暢，甚至凝滯不行的病理狀態(tài)）建議采用中藥復(fù)方調(diào)理。Department of traditional Chinese medi

9、cine consultationDialectical dignosis: Qi-deficiency causing blood stasis(a pathogenesis in traditional Chinese medicine(TCM).It is a morbid state of slow flow and even stasis of the blood resulting from Qi deficiency which makes the fuction of propelling and warming blood disturbed.)Recommended :Ap

10、ply drugs of TCM. 三、治療過(guò)程創(chuàng)面逐漸好轉(zhuǎn)，潰瘍面縮小，最終愈合The wound gradually improved, the ulcer surface reduced, and finally healed. 三、治療過(guò)程出院一年后隨訪：潰瘍無(wú)復(fù)發(fā)，外觀良好。 One year follow-up after discharge: no recurrence of ulcer, good appearance.一、背景資料(Background)二、病例資料(Case)三、治療過(guò)程(Treatment) 四、體會(huì)思考(Discussion) 四、體會(huì)思考避免自行艾灸需

11、專業(yè)醫(yī)師指導(dǎo)，正規(guī)醫(yī)療機(jī)構(gòu)，避免燙傷事件發(fā)生。Avoid self-moxibustionRequire professional medical guidanceRegular medical institutionsAvoid the occurrence of burns. 四、體會(huì)思考輔助治療調(diào)節(jié)心理狀態(tài) 更年期女性，治療周期長(zhǎng)，情緒波動(dòng)較大；中醫(yī)辨證調(diào)理，西藥控制癥狀，努力配合治療。Regulating mental state by complementary treatmentMenopausal women, the treatment is long time, emotional fluctuationsDiagnosis and treatment based on an overall analysis of the illness and the patients condition, and drugs control the symptoms, make efforts