臭氧辅助治疗对心外术后胸部浅表感染切口愈合的效果评价

Effect of adjuvant ozone therapy on wound healing of superficial chest infection after cardiac surgery

目的比较臭氧(Ozone)辅助下常规标准切口护理与常规标准切口护理对心外术后胸部浅表感染切口愈合、二次手术率、炎症介质、微生物定植和生活质量的影响。方法选取我院2016年3月至2018年3月心外科术后切口感染患者74例,将患者随机分为臭氧组和对照组,各37例。两组患者分别进行臭氧辅助下切口护理和常规标准切口护理,共20d。比较2组患者治疗前后局部创口面积、炎症介质、微生物定植数目和生活质量。结果治疗20d后,两组患者切口面积均缩小(P<0.05);臭氧组的创口面积小于对照组(t=7.63,P<0.01);臭氧组的创口愈合有效率高于对照组(91.89%vs.72.97%,P<0.05)。治疗11d后,两组患者血清IL-1β、IL-6、TNF-α水平较治疗前降低(P<0.01),且臭氧组低于对照组(P<0.01)。治疗20d后,臭氧组创口微生物定植数目显著少于对照组(P<0.05);臭氧组的生活质量量表评分(SF-36)显著高于对照组(P<0.05)。结论臭氧辅助下常规标准切口护理能调节创口局部炎症介质和微生物定植水平,改善切口愈合、生活质量和护理质量。我们推荐至少需要20次臭氧治疗才能有效。

Objective To compare the effects of ozone-assisted routine standard incision nursing and routine standard incision nursing on wound healing, secondary operation rate, inflammatory mediators,microbial colonization and quality of life in patients with superficial chest infection after cardiac surgery. Methods Totally 74 patients with incision infection after cardiac surgery in our hospital from March 2016 to March 2018 were randomly divided into ozone group and control group. The two groups were given ozone-assisted routine incision nursing and routine standard incision nursing respectively for 20 days. The local wound area, inflammatory mediators, the number of microbial colonization and quality of life were compared between the two groups before and after treatment. Results After 20 days of treatment, the incision area in ozone group was smaller than that in control group( P < 0. 01), and the effective rate of wound healing in ozone group was higher than that in control group( 91. 89%vs. 72. 97%,P < 0. 05). After 11 days of treatment, the serum levels of IL-1β, IL-6 and TNF-α in the two groups were lower than those before treatment( P < 0. 01), and the levels of IL-1β, IL-6 and TNF-α in ozone group were lower than those in control group( P < 0. 01). After 20 days of treatment, the number of microbial colonization in wounds in ozone group was less than that in control group( P < 0. 05),and the score of SF-36 in ozone group was significantly higher than that in control group ( P < 0. 05). Conclusion Conventional standard incision nursing assisted by ozone can regulate the level of local inflammatory mediators and microorganism colonization, and improve the wound healing,quality of life and nursing quality. We recommend that it is effective to be treated with ozone for at least 20 times.