自制新型低温硼酸湿性敷料治疗浅度烧伤患者面颈部创面效果的前瞻性随机对照研究

A prospective randomized controlled study of the therapeutic effects of a self-developed novel low-temperature boric acid wet dressing on the face and neck wounds of patients with superficial burns

目的观察并探讨自行研发的新型低温硼酸湿性敷料对浅度烧伤患者面颈部创面的临床治疗效果。方法采用前瞻性随机对照研究方法。选取2016年10月—2018年6月重庆市中医院皮肤科收治的符合入选标准的面颈部浅度烧伤(日晒伤)患者100例,病程均在15 d以内。采用随机数字表法将患者分为新型敷料组[男30例、女20例,年龄(55±14)岁]和常规敷料组[男28例、女22例,年龄(59±12)岁],新型敷料组患者面颈部创面采用自制的新型低温硼酸湿性敷料湿敷,常规敷料组患者面颈部创面采用常温硼酸溶液敷料湿敷,湿敷3次/d。对比2组患者首次治疗前及治疗14 d时(14 d内出院者记录出院当天数据)皮损面积及严重程度指数(EASI)和瘙痒视觉模拟评分法(VAS)的评分,治疗14 d时累计痊愈患者数,以及整体疗效。采用自制便利度调查问卷对操作护士进行调查,比较2种敷料操作所需时间及便利度。对数据行独立样本t检验或Mann-Whitney U检验。结果治疗前,2组患者的EASI和VAS评分比较,差异无统计学意义(t=1.576、1.492,P>0.05)。治疗14 d,新型敷料组患者的EASI评分为(2.4±0.4)分,明显低于常规敷料组的(4.6±0.7)分(t=3.552,P<0.01);新型敷料组患者的VAS评分为(0.51±0.12)分,明显低于常规敷料组的(0.98±0.19)分(t=3.496,P<0.01)。治疗14 d,新型敷料组患者日晒伤痊愈时间显著短于常规敷料组(Z=-6.690,P<0.01),日晒伤疗效显著优于常规敷料组(Z=3.787,P<0.01)。护士完成新型敷料操作所用时间显著短于常规敷料(Z=-5.575,P<0.01),且认为新型敷料的操作较常规敷料更方便(Z=-4.304,P<0.01)。结论新型硼酸湿性敷料较常规敷料可缩短浅度烧伤患者面颈部创面痊愈时间,提高治疗效率;同时新型敷料较常规敷料缩短了护士完成护理操作的时间且使用起来更加便利,是一种值得临床推广的新型浅度烧伤治疗材料。

Objective To observe and explore the clinical therapeutic effects of a self-developed novel low-temperature boric acid wet dressing on the face and neck wounds of patients with superficial burns.Methods A prospective randomized controlled study was conducted.One hundred cases of superficial burn(sunburn)patients who met the inclusion criteria were admitted to Department of Dermatology of Chongqing Hospital of Traditional Chinese Medicine from October 2016 to June 2018,the course of sunburn was less than 15 days.According to the of random number table,the patients were divided into new dressing(ND)group(30 males and 20 females,aged(55±14)years)and conventional dressing(CD)group(28 males and 22 females,aged(59±12)years).Patients in ND group were treated with a self-developed new low-temperature boric acid wet dressing,and patients in CD group were treated with normal temperature boric acid solution wet dressing,3 times a day.The Eczema area and severity index(EASI)score and Visual Analogue Scale(VAS)score of patients before and 14 days after treatment(patients discharged from hospital within 14 days were recorded on the day of discharge),the number of cured patients at 6,8,10,and 11 to 14 days after treatment,and the efficacy were compared between the patients in 2 groups.The nurse operators were investigated by self-made convenience questionnaire,and the time and convenience required of 2 dressings were compared.Data were statistically analyzed with independent sample t test or Mann-Whitey U test.Results Before the treatment,the EASI and VAS score in those two groups showed no significantly difference(t=1.576,1.492,P>0.05).At 14 days after treatment,the EASI score(2.4±0.4)points in ND Group was significantly lower than(4.6±0.7)points in CD Group(t=3.552,P<0.01);the VAS score(0.51±0.12)points in ND Group was significantly lower than(0.98±0.19)points in CD Group(t=3.496,P<0.01).At 14 days after treatment,the cured time of sunburns in ND Group was significantly shorter than that in CD Group(Z=-6.690,P<0.01);the treatment effects of ND Group showed better than that in CD Group(Z=3.387,P<0.01).The time for nurses operating ND was significantly shorter than that in CD(Z=-5.575,P<0.01);the nurses also believed the operation of ND was more convenient than CD(Z=-4.304,P<0.01).Conclusions Compared with that of CD,the application of ND can shorten the recovery time and improve the treatment efficiency.At the same time,the application of ND can significantly reduce the time of nursing operations,and the material is easy to use.This new material is worthy of clinical promotion for the treatment of superficial burns.