臭氧气浴联合常规换药治疗深Ⅱ度烧伤创面的临床效果评价

Clinical effect evaluation of ozone gas bath combined with conventional dressing change in the treatment of deep partial-thickness burn wounds

目的评价臭氧气浴联合常规换药治疗深Ⅱ度烧伤创面的临床疗效,为其临床应用提供依据。方法选择2019年6月至2020年9月武汉大学同仁医院暨武汉市第三医院收治的四肢烧伤后24 h内入院、烧伤面积≤15%总体表面积(TBSA)、且各肢体深Ⅱ度烧伤面积≥1%TBSA的患者37例。依据部位对称、面积相近、深度相同及同体对照原则,将每例患者创面分为臭氧气浴治疗组和对照组,每组共37个创面。臭氧气浴治疗组创面先以臭氧气浴熏蒸15 min,0.9%氯化钠溶液冲洗后重组人表皮生长因子(rhEGF)凝胶均匀涂抹,凡士林油纱布覆盖,无菌纱布包扎,隔日换药处理。对照组创面先以碘伏纱布湿敷15 min,再给予臭氧气浴治疗组创面相同换药方法。观察并记录2组创面疼痛评分、细菌感染率、愈合率、愈合时间以及是否存在不良反应。数据比较行t检验、χ^(2)检验。结果治疗后3、7、14 d,臭氧气浴治疗组视觉模拟评分法(VAS)评分均明显低于对照组,差异均有统计学意义(t=-20.17、-16.82、-16.35,P<0.05);治疗后3、7、14 d,取创面分泌物细菌培养,臭氧气浴治疗组细菌感染率均低于对照组,差异均有统计学意义(χ^(2)=6.51、7.24、12.28,P<0.05);治疗后7、14、21 d,臭氧气浴治疗组创面愈合率均高于对照组,差异均有统计学意义(t=3.86、5.29、4.27,P<0.05);臭氧气浴治疗组创面愈合时间为(18.37±3.18)d,比对照组[(23.46±4.95)d]短,差异有统计学意义(t=6.25,P<0.05)。臭氧气浴治疗组与对照组均未发生不良反应。结论深Ⅱ度烧伤创面应用臭氧气浴熏蒸治疗后,创面炎症反应减轻,疼痛明显缓解,无不良反应,患者舒适度提高,能够促进愈合,具有一定临床应用前景。

Objective To evaluate the clinical effect of ozone gas bath combined with conventional dressing in the treatment of deep partial-thickness burn wounds,and to provide the basis for its clinical application.Methods From June 2019 to September 2020,37 patients admitted to Tongren Hospital of Wuhan University&Wuhan Third Hospital within 24 hours after limb burns,with burns area less than 15%total body surface area(TBSA),and in which deep partial-thickness wound exceeded 1%TBSA in each limb were selected.The wounds of each patient was divided into ozone gas bath treatment group(n=37)and control group(n=37)based on the principles of location of symmetry,similarity in size,the same burn depth,and the homogenous contrast.Ozone gas bath treatment group was firstly to ozone fumigation bath for 15 minutes,rinsed with 0.9%sodium chloride solution,then the recombinant human epidermal growth factor(rhEGF)gel was evenly applied,covered with vaseline gauze,wrapped with sterile gauze,and dressing was changed every other day.In the control group,the wound was wet applied with iodophor gauze for 15 minutes,then the same as ozone gas bath treatment group dressing method.The score of pain,the infection rate of bacterial culture,the healing time,and adverse reaction in 2 groups were observed and compared.Data were processed with t test and chi-square test.Results Visual analogue scale(VAS)score of ozone gas bath treatment group were significantly lower than those in the control group at 3,7 and 14 days after treatment,the differences were statistically significant(t=-20.17,-16.82,-16.35;P<0.05).The infection rate in ozone gas bath treatment group were lower than those in the control group at 3,7 and 14 days after treatment,the differences were statistically significant(χ^(2)=6.51,7.24,12.28;P<0.05).At 7,14 and 21 days after treatment,the wound healing rate of ozone gas bath treatment group were higher than those of the control group,the differences were statistically significant(t=3.86,5.29,4.27;P<0.05).The healing time of ozone gas bath treatment group was(18.37±3.18)d,which was shorter than the control group[(23.46±4.95)d],and the difference was statistically significant(t=6.25,P<0.05).There were no adverse reactions in ozone gas bath treatment group and the control group.Conclusion After ozone gas bath fumigation treatment on deep partial-thickness burn wounds,the inflammation of the wound is relieved,the pain is relieved obviously,no adverse reaction,the comfort level of patients is improved,and the wound healing can be promoted,which has a certain clinical application prospect.