177例慢性伤口应用纳米银敷料的效果研究

Effects of nano-silver dressings on chronic wounds in 177 patients

目的观察慢性伤口长期使用纳米银敷料的有效性和安全性,为临床安全有效使用提供依据。方法 177例慢性伤口患者清洗清创后采用纳米银敷料覆盖,隔日更换1次至愈合或63d后研究结束,随访6个月。于干预前及干预后第7、14、28和63天取伤口分泌物行细菌培养,抽血检查肝肾功能。每次更换敷料时观察局部组织和皮肤有无不良反应,测量伤口面积,记录愈合时间。使用SPSS 16.0软件进行统计学分析。结果干预前检出9种细菌,阳性率67.23%(119/177),最常见的为金黄色葡萄球菌、铜绿假单胞菌和大肠杆菌。干预后第14、28、63天较干预前病原菌阳性率明显下降(P<0.05),干预28d、63d后伤口面积明显缩小(P<0.05),干预期内伤口愈合率59.89%(106/177),无不良反应和细胞毒性作用。结论纳米银敷料长期使用能有效抑制细菌生长,促进伤口愈合,安全有效。

Objective To observe the effectiveness and safety of long-term using nanosilver wound dressings in patients with chronic wounds in order to provide effective methods for wound care. Methods One hundred and seventy-seven patients with chronic wounds run into the study. Their wounds were cleaned,debrided and covered or filled with silver dressing,twice a day until healed no more than 63 days.The wound exudates was collected fbr hacteria culture and the patients blood samples were gained to test liver and kidney function index before the intervention and 7,14,28 and 63 days after intervention. The wound bed tissue,surrounding skin and adverse event were obseroed while changing dressings, wound size was measured every week,and healing time was recorded finally. Results Before intervention,119 patients were found with pathogenic bacteria（positive rate was 67.23%） with 9 bacteria species. The most common were Staphylococcus aureus,and Pseudomonas aeruginosa and Escherichia coll. By using silver dressing,the positive rate of pathogenic bacteria decreased after 14,28 and 63 days（P〈0.05）. Meanwhile, the wound size was more diminished after 28 and 63 days（P〈0.05）,and 106 patients with wounds healed in intervention duration,without any adverse event and cytocity. Conclusion Long-term using silver wound dressing can inhibiting bacteria growth and enhance wound healing effectively and safely in different chronic wounds.