正压给氧辅助治疗感染性伤口方法及时间的研究

Clinical research on the method and duration of pressurized topical oxygen therapy for treatment of infected wound

目的探讨正压给氧辅助治疗感染性伤口的给氧方法和给氧时间。方法将60例感染性伤口患者随机分为实验组、对照1组和对照2组各20例。对伤口常规清创及换药,根据细菌培养情况选用敏感抗生素。对照1组通过正压给氧装置将输氧管伸入氧罩内给氧30min。对照2组在对照1组基础上改进给氧方法,根据伤口大小将输氧管前端管侧戳1～5个侧孔,将输氧管伸入伤口内,给氧30min。实验组在对照2组基础上延长给氧时间至4h。三组均每日治疗1次。结果三组换药次数、愈合时间及治疗效果比较,差异有统计学意义(均P<0.01)。实验组给氧2h后金黄色葡萄球菌、枸橼酸杆菌、大肠埃希菌、变形杆菌生长受抑制,铜绿假单胞菌于给氧4h后生长受抑制。结论对感染性伤口将输氧管前端戳孔,近距离给氧并延长给氧时间至4h/次可减少换药次数,提高治疗效果。

Objective To explore the method and duration of pressurized topical oxygen therapy for treatment of infected wound.Methods Totally,60 patients who had infected wounds were equally divided into 3 groups at random.All the wounds of the 3 groups received routine deridement and dressing changes,and sensitive antibiotics were selected based on bacterial culture of the wounds.A pressurized topical oxygen therapy device was used in the 3 groups for oxygenation of the wounds.The wounds of the control group Ⅰ were oxygenated by using the oxygen tube inserting into the extremity chamber of the device.As for the control group Ⅱ,we made 1-5 pores at one end of the oxygen tube,and the tube was then inserted into the wounds and held in place for 30 min of oxygenation.The wounds of the experimental group were oxygenated in the same way as the control group Ⅱ,with duration of oxygenation being 4 h.Results The frequency of dressing changes,healing time and treatment effect had significant differences among the three groups（P0.01 for all）.After 2 hours of oxygenation,the growth of Staphylococcus.aureus,citrobacteramalonaticus,Escherichia.coli,and Bacillus proteus was inhibited.After 4 hours of oxygenation,the growth of Pseu-domonas.aeruginosa was inhibited.Frequency of oxygenation of wound was limited to once a day in every group.Conclusion For infected wound,pricking several pores at the end of the oxygen tube,making the oxygen tube close to the wound,and prolonging the duration of oxygenation to as long as 4 h can reduce changing frequency of dressings,and enhance treatment effect.