复合溶葡萄球菌酶消毒剂治疗烧伤后期创面感染的临床观察

Compound lysostaphin disinfectant treatment of burn wound infection in the latter part of the clinical observation

目的观察复合溶葡萄球菌酶消毒剂在治疗烧伤后期创面感染的疗效和安全性，评价其临床应用价值。方法对入选的60例烧伤后期创面感染患者，采用随机分组，在常规治疗的基础上，治疗组入院后创面应用复合溶葡萄球菌酶消毒剂（上海高科生物工程有限公司生产）溶液清创并湿敷，1次／d；对照组以庆大霉素＋0．9％氯化钠注射液纱布湿敷，1次／d。2组创面清洁后40例行清创植皮，治疗组及对照组各20例。检测创面菌群变化，比较两组累计细菌清除率、创面愈合时间及愈合率。结果治疗组用药后3、6、9d累计细菌清除率为45．8％、73．9％、89．5％，较对照组13．8％、27．6％、57．4％明显增高（P〈0．01）。创面愈合时间治疗组（12±5）d，较对照组（16±4）d明显缩短（P〈0．01）。创面愈合率治疗组明显高于对照组（P〈0．01）。用药后均未发现不良反应。结论烧伤后期创面感染应用复合溶葡萄球菌酶消毒剂治疗，有效地控制了感染、提高了植皮成活率、缩短了创面愈合时间，安全有效。

Objective To investigate the efficacy and safety of compound lysostaphin disinfectant solution in the latter stage of the treatment of bum wounds infection , and to evaluate its clinical value. Methods The selected 60 cases of bum wound infection were grouped into treatment and control group at random. The treatment group recieved compound lysostaphin disinfectant solution （Shanghai Hi-tech Co. bio-engineering, Ltd. ） with debridement and wet, once a day; the control group with normal saline ＋ gentamicin wet gauze, once a day. After cleaning the wound two groups 40 cases of underwent regular skin debridement, 20 cases in each group. The bacteria changes in the wound were detected, of bacteria removal the accumulated rate of wound healing time and healing rate were compared. Results 3, 6, 9 days after treatment the accumulated rate of bacteria removal was 45.8 %, 73.9 %, 89.5 % higher than the control group（ 13.8%, 27.6%, 57.4% ）respectively （P 〈0.01）. Wound healing time in the treatment group was （ 12 ± 5 ） d , shorter than the control group （ 16 ± 4） d was significantly （ P 〈 0. 01 ）. The rate of wound healing in the treatment group was significantly higher （P 〈 0.01 ）. No adverse reactions were found. Conclusion The treatment application of compound lysostaphin disinfectant in the later stage of burn wound is effective in control of infection, increases the survival rate of skin and shortens wound healing time, so it is safe and effective.