摘要
目的探讨安柯信银离子抗菌凝胶治疗慢性难愈性创面的临床作用。方法选取我院2014年1月~2015年1月收治入院的60例各类病因造成的慢性难愈性创面患者作为研究对象,根据处理方法不同分为实验组和对照组,各30例。两组创面均进行少量多次的清创处理,实验组采用安柯信银离子抗菌凝胶敷创面加纱布块包扎,对照组仅以碘伏凡士林纱布包扎。观察两组的疼痛评分、创面愈合率、创面愈合时间、换药后残余创面分泌物细菌培养阳性率及不良反应发生情况。结果实验组的疼痛评分显著低于对照组,创面愈合率显著高于对照组,创面愈合时间显著短于对照组,差异有统计学意义(P<0.05)。实验组第7、14天换药后残余创面的分泌物细菌培养阳性率均显著低于对照组,差异有统计学意义(P<0.05)。两组均无明显不良反应发生。结论安柯信银离子抗菌凝胶能够有效促进软组织缺损修复,缩短慢性难愈性创面的愈合时间。
Objective To investigate the clinical effect of Anscon Silver Ion Antibacterial Gel in the treatment of chronic refractory wounds.Methods Altogether 60 patients with chronic refractory wounds who were caused by various etiologies and treated in our hospital from January 2014 to January 2015 were selected as the object of this research and divided into the experiment group and the control group according to the different treatment methods,with 30 cases in each group.Wound debridement treatment was applied frequently with a small amount for each time in the two groups.The experiment group was applied with Anscon Silver Ion Antibacterial Gel and then wrapped up with a piece of gauze bandage,while the control group was w rapped only with Iodophor Vaseline gauze.The pain score,wound healing rate,wound healing time,the positive rate of bacterial culture of residual wound secretion and the incidence rate of adverse reactions after changed dressing were observed in the two groups.Results The pain score of the experimental group was significantly lower than that of the control group,the wound healing rate of the experimental group was significantly higher than that of the control group,the wound healing time of the experimental group was significantly shorter than that of the control group,with significant difference(P <0.05).The positive rate of bacterial culture of the residual wounds secretion after 7thand 14 thdays in the experimental group was significantly lower than that in the control group,with significant difference(P<0.05).There was no obvious adverse reaction in the two groups.Conclusion Anscon Silver Ion Antibacterial Gel can effectively promote the repair of soft tissue defect and shorten the healing time of chronic refractory wounds.
引文
[1]刘振峰,加亨,洪汉刚,等.中药外敷技术结合皮瓣移植治疗足踝部难愈性创面的临床研究[J].中成药,2015,37(5):1148-1150.
[2]方梅,柳晖,陈武鹏,等.综合护理干预应用于烧伤残余创面的疗效研究[J].护理研究,2010,24(10):2660-2661.
[3]方梅,柳晖,袁志敏,等.胰岛素联合生长因子及现代敷料处理慢性难愈性创面的临床研究[J].护理研究,2011,25(30):2762-2764.
[4]付小兵.进一步重视体表慢性难愈合创面发生机制与防治研究[J].中华创伤杂志,2004,20(8):449-451.
[5]费冀,陈久毅,张开伟,等.中药石香膏治疗慢性难愈合创面的多中心临床研究[J].中国实验方剂学杂志,2015,21(4):179-181.
[6]孙同柱,付小兵,赵志力,等.重组人血小板源性生长因子凝胶剂促进糖尿病大鼠创面愈合的实验研究[J].中国危重病急救医学,2003,15(10):596-599.
[7]卓燊,乔雪,陈君,等.复方愈疡散治疗糖尿病慢性难愈性创面的机制[J].中国实验方剂学杂志,2015,21(4):115-119.
[8]乔子轩,杨明.负压封闭引流结合外科治疗修复难愈性创面28例护理体会[J].创伤与急危重病医学,2015,3(3):179-181.
[9]韩飞,黎晴,刘华兴,等.激光辅助交互式湿性伤口治疗技术在难愈性创面的应用[J].中华整形外科杂志,2014,30(2):145-147.
[10]崔胜勇,刘琰,章雄.巨噬细胞功能障碍与糖尿病慢性难愈创面的关系[J].中华烧伤杂志,2014,30(3):264-269.
[11]曾勇,董肇杨,彭媛,等.医用生物胶体分散剂治疗深Ⅱ度烧伤创面的效果[J].中国医药导报,2015,12(13):83-86.
[12]李善友,郝岱峰,柴家科,等.难愈性创面细菌培养结果及药物敏感性分析[J].中华损伤与修复杂志(电子版),2014,9(4):66-68.
[13]陈方凯,李晓辉,龚海粟,等.MEBT/MEBO治疗慢性难愈性创面的临床疗效分析[J].中国烧伤创疡杂志,2014,26(2):119-124.
[14]孔婕.银离子敷料用于肛瘘术后创面愈合的疗效观察[J].中外医学研究,2014,12(33):93-95.
[15]潘德标,叶冠雄,吴成军,等.重组人碱性成纤维细胞生长因子与磺胺嘧啶银霜联合应用对慢性难愈性创面愈合过程的修复效应[J].温州医科大学学报,2014,44(4):294-296.