摘要
目的 了解压疮伤口感染病原菌的种类,分析长期使用纳米银敷料处理压疮的有效性,为临床压疮伤口的管理提供有效依据。方法 选择2011年9月-2015年8月在门诊和全院各科就诊处理的Ⅲ~Ⅳ期压疮患者55例,共60处压疮伤口,在全程整体干预的情况下,伤口按照统一方法评估、清洗和清创后采用纳米银抗菌敷料干预至伤口愈合或8周结束,伤口未愈者按湿性疗法继续换药至伤口愈合。观察干预前和干预后2、4、8周伤口病原菌检出率、压疮愈合计分的变化及干预期内伤口愈合率。结果 干预前检出病原菌12种,主要为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌,病原菌检出率为92.73%(51/55),使用纳米银敷料干预后不同时间段,伤口病原菌检出率和压疮愈合计分均有不同程度的降低(P〈0.01),干预4、8周后,伤口床改善显著,病原菌检出率和愈合计分下降更快;干预期内伤口愈合率为23.64%(13/55)。结论 压疮伤口感染发生率较高,使用纳米银敷料能有效清除伤口病原菌,促进伤口愈合。
Objective To research on the types of pathogenic bacteria in wound infection and analyze the effectiveness of long-term use of nano-silver dressing in the treatment of pressure ulcers, in order to provide references for the management of pressure ulcer wound. Methods Fifty-five patients (60 wounds) with stage Ⅲ - Ⅳ pressure ulcer wound treated in all departments between September 2011 and August 2015 were chosen to be our study subjects. Under overall intervention, all the wounds were assessed by the same method, cleansed and debrided, after which nano- silver antimicrobial dressing was used to intervene until the wound healed or the end of 8 weeks. The wounds which were not healed were treated with wet dressing therapy until wound healing. The detection rate of pathogenic bacteria before intervention and 2, 4 and 8 weeks after intervention, change of pressure ulcer healing score and the rate of wound healing were observed. Results Before the intervention, 12 kinds of pathogenic bacteria were detected, including mainly Escherichia coli, Pseudornonas aeruginosa, Staphylococcus aureus, and coagulase negative Staphylococci. The detection rate of pathogenic bacteria was 92.73% (51/55). With the use of nano-silver dressing during different time periods, the detection rate of pathogenic bacteria and the total score of pressure ulcer were lowered by varying degrees (P 〈 0.01). Four and 8 weeks after intervention, wound bed improved significantly and the detection rate of pathogenic bacteria decreased faster. The healing rate during the intervention period was 23.64% (13/55). Conclusions The incidence of pressure ulcer wound infection is high. The use of nano-silver wound dressing can effectively remove pathogenic bacteria and promote wound healing.
出处
《华西医学》
CAS
2016年第9期1484-1487,共4页
West China Medical Journal
基金
宜昌市卫生科技项目(A14301-07)
关键词
压疮
伤口感染
病原菌
纳米银敷料
伤口愈合
Pressure ulcer
Wound infection
Pathogenic bacteria
Nano-silver dressing
Wound healing