银纤维敷料联合负压伤口疗法治疗深Ⅱ度烧伤创面

Silver Fiber Dressing Combined with Negative Pressure Wound Therapy for Deep Second Degree Burn Wounds

目的:探讨银纤维敷料联合负压伤口疗法治疗深Ⅱ度烧伤创面的临床疗效。方法:选择笔者医院2016年6月-2018年7月住院治疗的68例深Ⅱ度烧伤创面患者作为研究对象,采用随机数字表法分为观察组和对照组,各34例。观察组应用银纤维敷料联合负压伤口疗法治疗,对照组应用磺胺嘧啶锌软膏外涂。记录各时点创面疼痛程度评分、创面渗液量、创面愈合率、创面完全愈合时间和细菌阳性率,观察不良反应发生情况,比较两组治疗21d的总显效率。结果:两组在治疗前及治疗后15min的创面疼痛程度评分上差异均无统计学意义(P>0.05);观察组治疗后即刻的创面疼痛程度评分明显低于对照组,差异有统计学意义(P<0.05)。观察组治疗7d、14d、21d后的创面渗液量均明显少于对照组,创面愈合率均明显高于对照组,创面完全愈合时间明显短于对照组,差异均有统计学意义(P<0.05)。治疗前两组创面分泌物细菌培养阳性率比较差异无统计学意义(P>0.05);治疗7d、14d后观察组创面分泌物细菌培养阳性率均明显低于对照组,差异均有统计学意义(P<0.05)。两组均顺利完成治疗,显著控制创面分泌物及肿胀,其中观察组治疗21d的临床总显效率为97.06%,明显高于对照组的82.35%,差异有统计学意义(P<0.05);两组治疗期间的血常规和心、肝、肾功能均无明显异常,未见过敏反应及与治疗相关的严重不良反应。结论:银纤维敷料联合负压伤口疗法治疗深Ⅱ度烧伤创面的临床疗效显著,在减轻换药疼痛程度、清除细菌、减少渗液和促进愈合上具有优势,且安全可靠,值得临床推广应用。

Objective To investigate the clinical efficacy of silver fiber dressing combined with negative pressure wound therapy in the treatment of deep second degree burn wounds.Methods 68 cases of deep second degree burn wounds treated in our hospital from June 2016 to July 2018 were selected as the study subjects,the patients were divided into the observation group and the control group by random number table,34 cases in each group.The observation group was treated with silver fiber dressing combined with negative pressure wound therapy,the control group was treated with sulfadiazine zinc ointment.The score of wound pain at each time point,the amount of wound seepage,the wound healing rate,the wound complete healing time and Bacterial positive rate were recorded,observed occurrence of adverse reactions,the total efficacy of the two groups for 21d was compared.Results There was no significant difference in the score of wound pain degree between the two groups before and 15min after treatment(P>0.05).The score of wound pain in the observation group were significantly lower than that in the control group immediately after treatment,the difference was statistically significant(P<0.05).The amount of wound seepage in the observation group at 7d,14d and 21d are significantly less than that in the control group,the wound healing rate was significantly higher than that in the control group,and the wound healing time was significantly shorter than that in the control group,the difference were statistically significant(P<0.05).There was no significant difference in the positive rate of bacterial culture of wound secretions between the two groups before treatment(P>0.05).After treatment for 7 and 14 days,the positive rate of bacterial culture of wound secretions in the observation group are significantly lower than that in the control group(P<0.05).The total effective rate of the observation group was 97.06%after 21 days of treatment,which was significantly higher than that of the control group(82.35%,P<0.05).Blood routine and cardiac,hepatic and renal functions of the two groups are not significantly abnormal during the treatment,and no allergic reactions or serious adverse reactions related to the treatment are observed.Conclusion Silver fiber dressings joint negative pressure wound therapy for deepⅡdegree burn wounds clinical curative effect is distinct,it has advantages in reducing the pain of dressing change,removing bacteria,reducing seepage and promoting healing,and the security is reliable,it is worthy of clinical application.