纳米银敷料结合封闭负压吸引对糖尿病性慢性创面患者愈合效果的影响

Effect of Nano-silver dressing combined with vacuum sealing drainage on the healing of diabetic patients with chronic wounds

目的探讨纳米银敷料结合封闭负压吸引治疗对糖尿病性慢性创面患者愈合效果的影响。方法选取2015年2月至2017年12月华北石油管理局总医院收治的糖尿病性慢性创面患者172例,分为纳米银组(60例),常规组(54例)和对照组(58例),纳米银组在常规封闭负压引流技术的基础上结合纳米银敷料治疗,常规组则采用常规封闭负压引流技术,对照组患者采用常规换药治疗。比较患者治疗14 d后肉芽生长情况、创面愈合率,记录创面愈合时间和治疗期间感染发生情况。结果纳米银组、常规组创面肉芽生长良好率均明显高于对照组,差异具有统计学意义(P分别=0.002和0.040),纳米银组、常规组创面肉芽生长良好率比较,差异无统计学意义(P=0.329);纳米银组、常规组和对照组中任意两组间创面愈合率比较,差异有统计学意义(P均<0.001);纳米银组、常规组和对照组中任意两组间创面愈合时间比较,差异均有统计学意义(P分别<0.001,=0.018和<0.001);纳米银组患者感染率明显低于常规组和对照组患者(P分别=0.006和0.040),常规组和对照组感染率比较,差异无统计学意义(P=0.501)。结论封闭负压吸引治疗可显著提高糖尿病性慢性创面愈合效果,结合纳米银敷料可有效预防感染。

Objective To investigate the effect of Nano-silver dressing combined with vacuum sealing drainage (VSD) on the healing of diabetic patients with chronic wounds. Methods A total of 172 patients with diabetic chronic wounds admitted in our hospital from February 2015 to December 2017 were selected and divided into Nano-silver group (n=60), conventional group (n=54) and control group(n=58), patients on Nano-silver group received Nano-silver dressing combined with VSD, patients on conventional group received VSD alone, and patients on control group received conventional dressing. The granulation growth, rate of wound healing after 14 days, time of wound healing and infection during the treatment, were compared between the three groups. Results The well growth rate of wound granulation on nano-silver group and the conventional group were significantly higher than that on control group (P=0.002 and 0.040, respectively), there was no significant difference on well growth rate of wound granulation between the nano-silver group and the conventional group (P=0.329). There were statistically significant difference between the any two groups on rate of wound healing and time of wound healing (P<0.001). There were statistically significant difference between the any two groups on time of wound healing (P<0.001,=0.018 and <0.001, respectively). The infection rate of nano-silver group was significantly lower than that of conventional group and control group(P=0.006 and 0.040, respectively), there was no significant difference on the infection rate between the conventional group and control group (P=0.501). Conclusion VSD can significantly improve the healing effect of diabetic chronic wounds, and Nano-silver antimicrobial dressing can effectively prevent infection.