锡类散联合创面护理凝胶对肛瘘患者术后创面及炎症水平的影响

Effect of Xilei Powder Combined with Wound Care Gel on Postoperative Wound and Inflammation Level of Anal Fistula Patients

目的:探讨锡类散联合创面护理凝胶对肛瘘患者术后创面及炎症水平的影响。方法:将80例肛瘘患者随机分为对照组、锡类散组、护理凝胶组、合用组,每组20例,均行肛瘘切除术,术后2d各组分别使用不同的纱条换药治疗,2次/d,直至创面完全愈合。在术后2d、7d采血,检测血清中相关炎性因子白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)、肿瘤坏死因子(TNF-α)浓度,并采用视觉模拟评分法(VAS)和分泌物评分法记录各组患者创面疼痛、分泌物情况,创面脓液细菌培养计算细菌清除率。结果:术后7d,锡类散组与创面凝胶组术后创面疼痛评分、炎性因子(IL-1β、IL-8、TNF-α)浓度均明显低于对照组(P<0.05),且这2组之间无明显差异(P>0.05),而合用组与其他3组相比均明显降低(P<0.05);合用组创面分泌物评分均明显低于其他3组(P<0.05),对照组、锡类散组、护理凝胶组各组间相比无明显差异(P>0.05);细菌培养结果显示,合用组创面细菌清除率均高于其他3组(P<0.05),对照组细菌清除率均低于其他3组(P<0.05),锡类散组与创面凝胶相比差异无统计学意义(P>0.05)。结论:使用锡类散联合创面护理凝胶用于肛瘘患者术后创面换药,可以通过减轻患者创面疼痛、减少创面分泌物,降低患者血清炎性因子IL-1β、IL-8、TNF-α浓度,提高细菌清除率,进而加速创面恢复。

Objective:To investigate the effect of Xilei powder combined with wound care gel on postoperative wounds and inflammation levels in patients with anal fistula.Methods:80 cases of anal fistula patients were randomly divided into control group,Xilei powder group,nursing gel group,combined group,20 cases in each group,all underwent anal fistula resection,2 days after operation,each group used different gauze to change dressing Treatment,2 times/d,until the wound is completely healed.Blood was collected at 2 and 7 days after surgery to detect the serum levels of interleukin-1β(IL-1β),interleukin-8(IL-8),and tumor necrosis factor(TNF-α)in serum.Visual The simulated scoring method(VAS)and the secretion scoring method recorded the wound pain and secretion of each group of patients,and the wound pus was cultured to calculate the bacterial clearance rate.Results:7 days after operation,the postoperative wound pain score and inflammatory factors(IL-1β,IL-8,TNF-α)concentration in the Xilei powder group and the wound gel group were significantly lower than those of the control group(P<0.05).And there was no significant difference between the two groups(P>0.05),while the combined group was significantly lower than the other 3 groups(P<0.05);the wound secretion scores of the combined group were significantly lower than those of the other 3 groups(P<0.05)),there was no significant difference between the control group,the Xilei powder group,and the nursing gel group(P>0.05);the bacterial culture results showed that the bacterial clearance rate of the combined group was higher than the other 3 groups(P<0.05)The bacterial clearance rate of the control group was lower than the other 3 groups(P<0.05),and the difference between the Xilei powder group and the wound gel was not statistically significant(P>0.05).Conclusion:The use of Xilei powder combined with wound care gel for dressing of wounds in patients with anal fistula after operation can reduce wound pain and secretions,and reduce serum inflammatory factors IL-1β,IL-8,and TNF-α.Concentration,increase the bacteria clearance rate,and accelerate the wound recovery.