新型湿性敷料应用于带状疱疹感染创面的疗效评价

The evaluation on efficacy of the new moist dressing in treating infected wounds in Herpes zoster patients

目的探讨新型湿性敷料藻酸盐银离子敷料、优拓SSD(磺胺嘧啶银脂质水胶敷料)和优拓水胶体敷料应用于带状疱疹感染创面的临床效果。方法选取本院神经内科住院的带状疱疹合并皮肤感染的患者78例,随机分为观察组和对照组,每组各39例。两组患者均给予同等剂量阿昔洛韦静滴,观察组采用新型湿性敷料(藻酸盐银离子敷料、优拓SSD敷料和优拓水胶体敷料)对皮损局部换药,对照组采用阿昔洛韦软膏和庆大霉素交替局部换药,观察两组患者在换药第3、6和9天感染控制情况、皮损干涸结痂及疼痛减轻情况、换药时患者疼痛程度、10天内平均每日换药护理耗时。结果在治疗后的第3天,观察组较对照组更有效(P<0.05);在治疗后的第6天,观察组较对照组的显效率更高(P<0.01);治疗后第9天,两组疗效比较差异无统计学意义(P>0.01);换药时患者创面疼痛观察组无或轻微疼痛所占比例较对照组更高(P<0.01),且疼痛耐受性更强。观察组10天内平均每天换药护理时间更短(P=0.000)。结论新型湿性敷料(藻酸盐银离子敷料、优拓SSD敷料和优拓水胶体敷料)对疱疹皮肤破溃合并感染后的皮损疗效肯定,能明显控制皮肤破溃及感染情况,减轻疼痛、缩短病程,可在临床推广应用。

Objectives The study aimed to investigate the efficacy of the new moist dressing （Alginate silver ion dressing , Sulfadiazine silver lipid water gel dressing （SSD） and hydrocolloid dressing） for treating infected wounds in the patients with Herpes zoster （HZ）. Methods Randomized controlled study design was employed, and the patients suf- fered from HZ with wound infection were included in the study. All of them were randomly divided into observation and control groups. The observation group was treated with alginate silver ion dressing, sulfadiazine silver lipid water gel dressing （SSD） or hydrocolloid dressing depending on the infected wounds＇ situation, and the control group was alternately treated with Aciclovir Ointment and gentamicin on the infected wounds. In addition, both groups were treated with the same dosage of Acyclovir （0.5g, Q8h, ivgtt）. The situation about the infection controlling, skin lesions and pain relief on the 3th, 6th and 9th day after different treatment were observed. Patients＇ degree of pain during each treatment and average consumed nursing time in each day during the first 10 days were also be recorded; Results A total of 78 patients were enrolled in the study and divided into two groups, each group consisting of 39 subjects. A better efficiency （Total effective rate： 29（74.4%） Vs. 20（51.3%）, P〈0.05） was found in the observation group at the 3th day after treatment, and the rate of marked efficacy was higher in the observation group （32（82.1%） Vs. 18（46.2%）, P〈0.01） at the 6th day. However, no significant difference between both groups was observed at the 9th day. Meanwhile, the proportion of no or slight pain in the observation group was higher than that in the control group （100% Vs. 83.3%） during the first two treatments, and the average daily change dressing time spent in the observation group was less than that in the control group （P=0. 000）. Conclusion The data suggested that the new moist dressing had a better efficacy for infected skin lesions in HZ than traditional methods. It can obviously improve the speed in wounds healing, control the infection of skin, relieve pain and shorten the course of the disease.