微环境治疗改善难治性创面细菌耐药疗效分析

Clinical Analysis of Individualized Treatment for Microenvironment in Reducing Occurrence of Strain with Bacterial Drug Resistance in Treatment of Refractory Wounds

目的探讨创面微环境个体化治疗在改善难治性创面细菌耐药中的应用。方法整群选取2013年6月—2015年6月期间在该院完成治疗的63例非手术难治性创面患者随机分为个体化治疗组和常规治疗组,个体化治疗组31例,常规治疗组32例,治疗前比较两组患者在性别、年龄方面差异无统计学意义。在全身治疗的基础上,将耐药突变选择窗理论应用于临床,设计创面微环境个体化治疗方案,对两组患者治疗前后分别进行创面分泌物细菌培养及药敏试验检测,统计分析所得数据。结果个体化治疗组中9例（9/31）检出耐药菌,常规治疗组中21（21/32）例检出耐药菌,差异有统计学意义（χ~2=8.45,P〈0.05）。结论创面微环境个体化治疗能够有效的改善难治性创面患者治疗中广泛耐药菌感染状况。

Objective To investigate the clinical value of the individualized treatment for microenvironment in reducing oc-currence of strain with bacterial drug resistance in the treatment of refractory wounds. Methods 63 patients hospitalized in our wards from June 2013 to June 2015 were divided into the individual treatment group （ITG, n=31） and the conventional treatment group （CTG, n=32） according to the random number table. There were no differences in sex or age before treat-ment between the two groups. The individualized treatment for microenvironment was made according to the mutant selec-tion windows theory, which was used in guiding the clinical treatment. Patients in both groups were treated with internal medical therapy and nursing, and individualized treatment were added to study group, while conventional treatment were added to control group. Bacterial culture of wound exudate and drug sensitivity test were performed before and after treat-ment in two groups. The data obtained were employed to proceed on the statistical analysis and the table production. Re-sults 9 cases（9/31）in ITG were proved to be infected by drug-resistance bacteria ,compared with 21 cases（21/32）in CTG. Significant differences were found between the two groups,χ2=8.45, P〈0.05. Conclusion It is effective to use the individual-ized treatment for microenvironment to reduce occurrence of strain with bacterial drug resistance in the treatment of refrac-tory wounds.