两种抗菌银敷料在伤口细菌生物膜感染中的应用效果与成本效益分析

Effect and cost-effectiveness analysis on using two antibacterial silver dressings on infection of wound with bacterial biofilm

目的:比较两种抗菌银敷料对伤口细菌生物膜感染的治疗效果,并进行成本效益分析。方法:选取2019年8月—2020年10月在伤口门诊就诊的有细菌生物膜感染的慢性伤口病人共70例,随机分为试验组和对照组各35例。两组在湿性疗法基础上,试验组采用羟甲基纤维素钠银敷料,对照组使用银离子藻酸盐抗菌敷料,均治疗28 d。比较两组病人伤口面积缩小率、伤口压疮愈合计分、伤口细菌生物膜临床识别指标发生例数、换药次数、治疗成本效益比和增量成本效益比。结果:试验组退出1例,对照组退出2例。治疗14 d、28 d,试验组伤口面积缩小率和伤口压疮愈合计分与对照组比较差异均有统计学意义(均P<0.05)。治疗28 d时,试验组伤口细菌生物膜临床识别指标发生总例数少于对照组(P<0.05),且对照组伤口与试验组相比每多愈合1 cm2,需要多花费105.02元。结论:两种抗菌银敷料对治疗慢性伤口均有一定效果。与银离子藻酸盐抗菌敷料比较,羟甲基纤维素钠银敷料效果更优,更具有成本经济效益。

Objective:To compare the effect and the cost-effectiveness of two antibacterial silver dressings on infection of wound bacterial biofilm.Methods:A total of 70 chronic wound patients with bacterial biofilm infection who visited the wound clinic from August 2019 to October 2020 were selected and randomly divided into experimental group and control group,with 35 cases in each group.On the basis of wet therapy,sodium silver dressing of hydroxymethyl cellulose was used in the experimental group and silver ion alginate antibacterial dressing was used in the control group.Both groups were treated for 28 days.The wound area reduction rate,PUSH score,the number of clinical indicators of wound bacterial biofilm,dressing change times,treatment cost-effectiveness ratio and incremental cost-effectiveness ratio were compared between the two groups.Results:One patient in the experimental group and two in the control group quit.There were statistically significant differences in wound area reduction rate and PUSH score between the experimental group and the control group at 14 and 28 days after treatment(P<0.05).After 28 days of treatment,the total number of clinical identification indicators of wound bacterial biofilm in the experimental group was less than that in the control group(P<0.05),and the wound in the control group needed 105.02 yuan more for each 1 cm2 more than that in the experimental group.Conclusions:The two antibacterial silver dressings had certain effects on the treatment of chronic wounds.Compared with the silver ion alginate antibacterial dressing,the effect of sodium hydroxymethyl cellulose silver dressing was better and more cost-effective.