温敏型羟丁基壳聚糖对感染性创面的疗效研究

Study on the efficacy of thermosensitive hydroxybutyl chitosan on infected wounds

目的研究温敏型羟丁基壳聚糖治疗感染性创面的疗效。方法60例感染性创面患者,根据随机数字表法分为实验组及对照组,每组30例。两组患者均进行感染性创面常规治疗,实验组换药时加用温敏型羟丁基壳聚糖。比较两组患者住院时长、创面愈合时间、住院期间换药次数,治疗前后视觉模拟评分法(VAS)评分、C反应蛋白(CRP)、白细胞计数(WBC)、血沉(ESR)及治疗后12个月患者与观察者瘢痕评估量表(POSAS)评分。结果实验组患者住院时长(14.83±2.76)d、创面愈合时间(13.83±2.76)d短于对照组的(18.93±4.51)、(17.93±4.51)d,住院期间换药次数(5.14±2.02)次少于对照组的(9.75±2.69)次,差异有统计学意义(P<0.05)。治疗后第1、3、7天,两组VAS评分均低于治疗前,差异具有统计学意义(P<0.05);治疗后第1天,两组VAS评分比较差异无统计学意义(P>0.05);治疗后第3、7天,实验组VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗后第3、7天,两组患者CRP、WBC、ESR水平均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。实验组观察者评分(20.27±6.15)分、患者评分(22.03±6.67)分均低于对照组的(30.80±6.72)、(34.03±8.24)分,差异有统计学意义(P<0.05)。结论温敏型羟丁基壳聚糖在治疗感染性创面方面具有较好的疗效,可以有效减少患者的住院时间,缩短创面愈合时间,减少换药次数,减轻疼痛,有效抑制炎症水平。

Objective To study the efficacy of thermosensitive hydroxybutyl chitosan on infected wounds.Methods A total of 60 patients with infectious wounds were divided into experimental group and control group according to the random numerical table,with 30 cases in each group.Both groups received conventional treatment for infected wounds,and the experimental group was additionally given thermosensitive hydroxybutyl chitosan during dressing change.Both groups were compared in terms of length of hospital stay,wound healing time,the number of dressing changes during hospitalization,visual analogue scale(VAS)score,C-reactive protein(CRP),white blood cell count(WBC),erythrocyte sedimentation rate(ESR)before and after treatment,and patient and observer scar assessment scale(POSAS)score after 12 months of treatment.Results The length of hospital stay(14.83±2.76)d and the wound healing time(13.83±2.76)d in the experimental group were shorter than(18.93±4.51)and(17.93±4.51)d in the control group;the number of dressing changes during hospitalization(5.14±2.02)times in the experimental group was less than(9.75±2.69)times in the control group;the difference were all statistically significant(P<0.05).On the 1st,3rd,and 7th days after treatment,the VAS scores of the two groups were lower than those before treatment,and the differences were all statistically significant(P<0.05).On the first day after treatment,there was no statistically significant difference in VAS scores between the two groups(P>0.05).On the 3rd and 7th days after treatment,the VAS score of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).On the 3rd and 7th days after treatment,the levels of CRP,WBC,and ESR in the two groups were lower than those before treatment in this group,and the experimental group was lower than the control group,and the differences were all statistically significant(P<0.05).The observer's score(20.27±6.15)points and the patient's score(22.03±6.67)points in the experimental group were lower than(30.80±6.72)and(34.03±8.24)points in the control group,and the differences were all statistically significant(P<0.05).Conclusion Thermosensitive hydroxybutyl chitosan has good efficacy in the treatment of infected wounds,which can effectively reduce patients'length of hospital stay,shorten their wound healing time,reduce the number of dressing changes,alleviate patients'pain and effectively suppress the level of inflammation.