无菌生物膜在小儿浅Ⅱ度烧伤创面中的临床应用  

Clinical application of sterile biological films in treatment of pediatric superficial Ⅱ burn wounds

作　　者：常菲[1] 房贺[1] 贲道锋[1] 罗鹏飞[1] 郑勇军[1] 张梅[1] 夏照帆[1] 路卫[1] 

机构地区：[1]第二军医大学附属长海医院烧伤外科,上海200433

出　　处：《中华损伤与修复杂志（电子版）》2013年第4期30-33,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：第二军医大学干细胞与医学研究中心研究生创新实验课题(SCMRC1212)

摘　　要：目的研究无菌生物膜在小儿浅Ⅱ度烧伤创面治疗中的作用。方法回顾性分析第二军医大学附属长海医院烧伤外科2010年7月至2012年6月收治的四肢及躯干浅Ⅱ度烧伤患儿50例,年龄2～9岁,烧伤面积2%～6%TBSA。按治疗方法不同分为两组,治疗组以无菌生物膜覆盖创面后包扎,对照组用磺胺嘧啶银霜换药治疗。分别统计两组创面的愈合时间、创面愈合率、平均换药次数、更换最内层药用纱布/生物膜的平均次数,并取创面分泌物进行细菌培养,同时定期监测两组患儿在用药期间有无实验室检测指标异常及不良反应。结果与对照组相比,治疗组的创面愈合时间明显缩短[(9.84±1.42)dvs(11.89±1.78)d],差异具有统计学意义(P<0.05),治疗第7、11天创面愈合率均增高[(59.38±8.21)%vs(52.11±11.10)%,P<0.05;(98.88±3.06)%vs(89.94±6.20)%,P<0.05)],平均换药次数及更换最内层药用纱布平均次数均明显降低(3.88±0.98vs7.83±1.10,P<0.05;0.38±0.49vs6.83±1.10,P<0.05)。两组创面细菌培养阳性率的差异无统计学意义。治疗期间所有受试患儿血常规、肝肾功能等相关指标无异常波动,绝大多数患儿无不适主诉。结论小儿浅Ⅱ度创面治疗中应用无菌生物膜,能明显缩短创面愈合时间,提高创面愈合率,显著减少换药次数,减轻患者痛苦,促进创面愈合。Objective To evaluate the clinical effects of sterile biological films in treatment of pediatric superficial lI bum wounds. Methods Fifty cases of inpatients with superficial II burns in department of bum surgery in Changhai hospital from July 2010 to June 2012 were included in this study and divided into 2 groups on the basis of treatment methods. The hum wounds in the treatment group were covered with sterile biological film and those in the control group were managed with SD-Ag. The healing time, recovering rate, the frequency of dressing changes, the frequency of changing the inner most layer gauze and the rate of infection of wounds were measured. Meanwhile, the laboratory abnormalities and adverse effect were regularly monitered during the treatment. Results Compared with the control group, the treatment group exhibited a significantly shorter healing time [ （9.84 ± 1.42） d vs （ 11.89 ± 1.78 ） d, P 〈 0.05） ]. The treatment group also had higher recovering rates [ （59.38 ± 8.21 ） % vs （52. 11 ± 11.10） %, （98.88 ±3.06）% vs （89. 94 ±6. 20）%, P〈0.05 respectively] on the 7th and llth day after treatment. Moreover, sterile biological films also resulted in significantly reduced dressing changes and the innermost layer changes （3.85 ±0.98 vs 7. 83 ± 1. 10, 0. 38 ±0. 49 vs 6. 83 ± 1. 10, P 〈0.05 respectively）. However, the outcomes of bacterial culture were not significantly different between the two groups. There was no direct relationship between the laboratory abnormalities and the therapeutic measures during the study, and most patients had no uncomfortable chief complaint. Conclusion Sterile biological films can shorten the healing time, improve healing rate, decrease frequency of dressing change, alleviate patients＇ pain and promote wound healing for superficial ]I burn wound in pediatric patients.

关 键 词：烧伤 无菌生物膜 伤口愈合 

分 类 号：R726.5[医药卫生—儿科]