纳米银抗菌敷料应用对糖尿病足患者感染控制的研究

Effect of nano-silver antimicrobial dressings on control of infections in patients with diabetic foot

目的探讨应用纳米银抗菌敷料换药对糖尿病足患者感染控制的研究,为临床治疗提供参考依据。方法调查2012年1月-2014年1月共120例糖尿病足患者的临床资料,随机分组为凡士林敷料常规换药组(常规组)和纳米银抗菌敷料换药组(试验组),每组各60例;对两组患者治疗过程中溃疡面愈合时间、换药次数及感染发生的控制情况进行分析,数据采用SPSS 17.0软件进行统计分析。结果常规组有23例患者发生感染,感染率为38.33%;试验组有11例患者发生感染,感染率为18.33%;所有患者糖尿病足均得到显著好转,Wagner分级为0级;试验组患者溃疡面愈合时间、换药次数及住院时间分别为(14.9±2.7)d、(9.6±3.5)次及(16.7±3.1)d,显著低于常规组(28.6±5.3)d、(19.7±5.0)次及(33.2±6.6)d,差异有统计学意义(P<0.05);试验组患者溃疡面感染控制时间为(4.6±2.8)d,显著低于常规组(8.7±3.9)d;试验组细菌感染例数显著低于常规组,但两组间病原菌分布比较差异无统计学意义。结论使用纳米银抗菌敷料能够显著减少糖尿病足患者感染的发病率及溃疡面愈合时间,有助于缩短疗程,控制感染。

OBJECTIVE To investigate the application of nano‐silver antimicrobial dressings on control of infections in the patients with diabetic foot so as to provide guidance for clinical treatment .METHODS A total of 120 patients with diabetic foot who were treated in the hospital from Jan 2012 to Jan 2014 were enrolled in the study and ran‐domly divided into the conventional petrolatum dressing group （the conventional group） and the nano‐silver antimi‐crobial dressing group （the experimental group） ,with 60 cases in each group .The wound healing time ,frequency of drug dressing ,and incidence of infections were observed and compared between the two groups during the treat‐ment ,and the statistical analysis of data was performed with the use of SPSS 17 .0 software .RESULTS The infec‐tions occurred in 23 cases in the conventional group with the infection rate of 38 .33% ;the infections occurred in 11 cases in the experimental group with the infection rate of 18 .33% .The diabetic foot of all the participants was remarkably improved ,with the Wagner classification of grade 0 .The wound healing time of the experimental group was （14 .9 ± 2 .7 ）days ,significantly shorter than （28 .6 ± 5 .3 ）days of the conventional group ;the frequen‐cy of drug dressing of the experimental group was （9 .6 ± 3 .5）times ,significantly less than （19 .7 ± 5 .0）time of the conventional group ;the length of hospital stay of the experimental group was （16 .7 ± 3 .1 ）days ,significantly shorter than （33 .2 ± 6 .6 ）days of the conventional group （P〈0 .05） .The time of control of wound infections was （4 .6 ± 2 .8）days in the experimental group ,significantly shorter than （8 .7 ± 3 .9）days in the conventional group . The incidence of bacterial infections of the experimental group was significantly lower than that of the conventional group ,however ,there was no significant difference in the distribution of pathogens between the two groups . CONCLUSION The nano‐silver antimicrobial dressing can effectively reduce the incidence of infections in the dia‐betic foot patients and shorten the wound healing time as well as the treatment course so as to control the infec‐tions .