32例麻风继发性溃疡分析

Analysis of secondary ulcers in 32 leprosy recuperators

目的:了解我院麻风休养员继发性溃疡情况,以便更好地预防和治疗继发性溃疡。方法:使用继发性溃疡调查表调查32例麻风继发性溃疡患者的病因、性质、部位等情况并取继发性溃疡处的分泌物进行细菌培养及药敏试验。结果:32例麻风继发性溃疡共39个病灶。发病部位:足底33个病灶,小腿和手指各3个病灶。溃疡分型:复杂性溃疡灶35个(89.74%),单纯性溃疡灶4个(10.26%)。溃疡原因:灼烫伤引起3个溃疡灶,压力性损伤引起36个溃疡灶。溃疡灶的细菌感染情况:26个病灶无细菌感染,13个存在细菌感染(33.3%),菌种及药敏情况分别为:金黄色葡萄球菌6株,仅对药物利福平敏感;铜绿假单胞菌4株,对药物庆大霉素、头孢他啶、妥布霉素、环丙沙星、左氧氟沙星、阿米卡星均敏感;奇异变形杆菌、普通变形杆菌、大肠埃希菌各1株,均对头孢他啶、阿米卡星敏感。结论:本地区麻风继发性溃疡以足底溃疡、复杂性溃疡为主,受伤原因以压力性损伤引起为主,感染病原菌以金黄色葡萄球菌为主。

Objective： To investigate the condition of secondary ulcers in the leprosy recuperators in order to improve the methods of preventing and treatment for ulcers. Methods： Thirty two patients with secondary ulcers were investigated through the ulcer questionnaires. The disease causes,nature and location of each ulcer were mainly investigated. Bacterial culture and drug sensitivity test were taken from the secretions of ulcers.Results： There were 39 lesions in 32 cases including 35 complex ulcer and 4 simplex ulcer. Of 39 lesions,33 in the sole,3 in leg and 3 in finger. The cause of ulcer included burns（ 3 lesions） and pressure injury（ 36 lesions）. There were bacterial infections in 13 lesions and no bacterial infections in 26. Of 13 bacterial infections lesions,6 strains of Staphylococcus aureus were sensitive only to rifampicin,4 of Pseudomonas aeruginosa were sensitive to gentamicin,ceftazidime,tobramycin,ciprofloxacin,levofloxacin and amikacin,one of Proteus mirabilis,one of Proteus vulgaris and one of Escherichia coli were all sensitive to ceftazidime and Amikacin. Conclusion： The secondary ulcers in the leprosy recuperators are mainly plantar ulcers and complicated ulcers,the main cause of the injury is pressure damage,and the main pathogens is Staphylococcus aureus.