液体伤口敷料在治疗慢性溃疡创面中的临床应用

CLINICAL APPLICATION OF LIQUID WOUND DRESSING IN TREATMENT OF CHRONIC ULCER WOUNDS

目的探讨采用液体伤口敷料治疗慢性溃疡创面的效果。方法2014年1月-2015年10月，将收治并符合选择标准的84例慢性溃疡创面患者随机分为两组，44例采用液体伤口敷料换药（治疗组），40例采用常规换药方案（对照组）。两组患者性别、年龄、诱因、创面部位、创面面积以及病程等一般资料比较，差异均无统计学意义（P〉O．05），具有可比性。记录并比较两组患者换药次数、治疗有效率、创面愈合时间及治疗后第5、10、20天创面愈合率、第1、5、10天细菌培养阳性率、治疗期间不良反应发生情况；于溃疡创面愈合后6个月，参照温哥华瘢痕评定量表，评价创面愈合后瘢痕情况。结果治疗组治疗有效率达100％，显著高于对照组的85％（P=O．009）。治疗期间，治疗组换药（11．36±3．40）次，显著少于对照组的（16．94±4．51）次（t=-6．231，P=0．000）。治疗组第5、10、20天创面愈合率均显著高于对照组（P〈0．05），创面愈合时间亦较对照组显著缩短（t=-6．627，P=0．000）。治疗后第1天，治疗组细菌培养阳性率与对照组相似（X2=O．066，P=O．797），第5、10天显著低于对照组（X2=12．313，P=O．000；P=0．005）。对照组4例出现不良反应，其余患者均未见严重不良反应。溃疡创面愈合后6个月，参照温哥华瘢痕评定量表评分，治疗组为（8．59±1．32）分，显著低于对照组的（9．85±1．65）分（扛-3．752，P=0．000）。结论液体伤口敷料治疗慢性溃疡创面能明显促进创面愈合，缩短愈合时间，减少换药次数，改善患者预后。

Objective To evaluate the effectiveness of liquid wound dressing in the treatment of chronic ulcer wounds. Methods Between January 2014 and October 2015, 84 patients with chronic ulcer wounds were included and divided into 2 groups randomly. The chronic ulcer wounds were covered with liquid wound dressing in the treatment group （n=44） and were managed with iodophor in the control group （n=40）. There was no significant difference in age, gender, causes, location, wound area, and disease duration between 2 groups （P〉0.05）. The frequency of dress changing, effective rate of treatment, wound healing time, wound healing rate at 5, 10, and 20 days, positive rate of bacteria culture at 1, 5, and 10 days, and the rate of side effect were recorded and compared between 2 groups. Vancouver scar scale was used to evaluate scar formation. Results The effective rate of the treatment group （100%） was significantly higher than that of the control group （85%） （P=0.009）. The frequency of dress changing in the treatment group [（11.36±3.40） times] was significantly lower than that in the control group [（16.94＋4.51） times] （t= -6.231, P=0.000）. The wound healing rates at 5, 10, and 20 days were significantly increased （P〈0.05） and the wound healing time was significantly decreased （t= -6.627, P=0.000） in the treatment group when compared with the control group. The positive rates of bacteria culture at 5 and 10 days in the treatment group were significantly lower than those in the control group （X2=12.313, P=0.000; P=0.005）, but no significant difference was found at 1 day （X2=0.066, P=0.797）. Side effect was observed in 4 cases of the control group. Vancouver scar scale score was 8.59±1.32 in the treatment group and was 9.85±1.65 in the control group, showing significant difference （t= -3.752, P=0.000）. Conclusion The application of the liquid wound dressing in the treatment of chronic ulcer wound can improve the wound healing rate, shorten the healing time and decrease the frequency of dress change, which could promote the wound healing process.