湿润烧伤膏在肛瘘术后创面中的应用效果分析

Clinical Efficacy of MEBO in the Treatment of Anal Fistula Postoperative Wounds

目的探究分析湿润烧伤膏在肛瘘术后创面中的应用效果。方法选取2022年1月至2023年7月于祥云县人民医院接受手术治疗的86例肛瘘患者作为研究对象,按照术后创面不同治疗方法将其分为研究组(43例)和对照组(43例),研究组患者术后创面予以复方黄柏液联合湿润烧伤膏药纱换药处理,对照组患者术后创面予以复方黄柏液联合凡士林油纱换药处理,对比观察两组患者炎症指标水平、术后创面肉芽组织生长情况、创面渗出情况、临床疗效及创面愈合时间。结果术后第4天,研究组患者白细胞计数、中性粒细胞计数、降钙素原水平均明显低于对照组(t/Z=2.266、2.160、-2.606,P=0.026、0.031、0.009);术后第7、14天,研究组患者肉芽组织生长情况均明显优于对照组(Z=-2.810、-3.334,P=0.005、0.001);术后第3、7、14天,研究组患者创面渗出情况均明显轻于对照组(Z=-2.096、-2.150、-3.369,P=0.036、0.032、0.001);治疗14 d后,研究组患者中治愈2例、显效22例、有效15例、无效4例,明显优于对照组患者的治愈1例、显效8例、有效17例、无效17例(Z=-3.778,P<0.001);研究组患者创面愈合时间为19(17,21)d,明显短于对照组患者的创面愈合时间24(20,26)d(Z=-4.776,P<0.001)。结论与复方黄柏液联合凡士林油纱相比,肛瘘术后应用复方黄柏液联合湿润烧伤膏药纱处理创面,更能有效降低炎症反应程度,加快肉芽组织生长,减少创面渗出,促进创面愈合。

Objective To study the clinical efficacy of MEBO in the treatment of anal fistula postoperative wounds.Methods 86 patients with anal fistula,admitted to the People’s Hospital of Xiangyun County from January 2022 to July 2023 for surgical treatment,were enrolled as research subjects and then divided into the study group(n=43)and the control group(n=43)according to the different managements for postoperative wounds.After the surgical treatment for anal fistula,the postoperative wounds of patients were treated with dressing change of Fufang Huangbaiye in combination with MEBO⁃impregnated gauze in the study group,whereas the postoperative wounds of patients in the control group with the dressing change of Fufang Huangbaiye in combination with Vaseline gauze.The inflammatory factor level,wound granulation tissue growth,wound exudation,clinical efficacy and wound healing time were compared between the two groups.Results On day 4 after surgery,the white blood cell count,neutrophil count,and procalcitonin level of the patients were all signifi⁃cantly lower in the study group compare with the control group(t/Z=2.266,2.160 and-2.606,P=0.026,0.031 and 0.009).Respectively on day 7 and 14 after surgery,the granulation tissue growth condition of the patients in the study group were significantly better than that in the control group(Z=-2.810 and-3.334,P=0.005 and 0.001).Respectively on day 3,7 and 14 after surgery,the wound exudation condition of patients in the study group was significantly milder than that in the control group(Z=-2.096,-2.150 and-3.369,P=0.036,0.032 and 0.001).After 14 days of treatment,2 cases were cured,22 cases showed markedly effective,15 cases effective and 4 cases ineffective in the study group,which was significantly better than that in the control group(Z=-3.778,P<0.001)⁃1 case cured,8 cases markedly effective,17 cases effective and 17 cases ineffective.The wound healing time of the patients was 19(17,21)d in the study group,which was significantly shorter than the corresponding 24(20,26)d of the patients in the control group(Z=-4.776,P<0.001).Conclusion Compared with the application of Fufang Huangbaiye in combination with Vaseline gauze in the management of the postoperative wounds of anal fistula surgery,the application of Fufang Huangbaiye in combination with MEBO⁃impregnated gauze can effectively decrease the inflammatory responses of patients,accelerate granulation tissue growth,reduce wound exudation,and promote wound healing.