皮肤创面无机诱导活性敷料联合纳米银医用抗菌敷料治疗糖尿病患者足部慢性溃疡  

Treatment of chronic diabetic foot ulcer with the combination of an inorganic activity induced skin wound dressing and a nano-silver dressing

作　　者：齐常萍[1] 牟怡平[1] 

机构地区：[1]沈阳医学院附属中心医院手外科,沈阳110024

出　　处：《中华老年医学杂志》2014年第6期635-637,共3页Chinese Journal of Geriatrics

摘　　要：目的观察皮肤创面无机诱导活性敷料（德莫林）联合纳米银医用抗菌敷料治疗老年糖尿病患者足部慢性溃疡的疗效。方法共收治老年糖尿病足部慢性溃疡患者93例，随机将患者分成治疗组和对照组，两组患者在进行内科治疗和局部换药的基础上，治疗组外敷德莫林联合纳米银医用抗菌敷料，对照组患者创面则覆盖0．5％碘伏油纱布，比较两组患者创面愈合情况、创面愈合时间和创面菌培养阳性率。结果治疗组平均治疗时间（41．6±2．7）d，明显短于对照组（61．9±2．9）d（t=-35．09，P=0．000）；治疗组患者入院时、入院14d和28d细菌培养阳性率分别为88．46％、23．07％和15．38％，对照组分别为88．89％、59．26％和40．74％（X^2=0．01、6．88、7．34，P=0．065、0．008、0．006）。对照组47例患者有效率63．83％（30／47），显著低于治疗组82．61％（38／46）（X^2=4．17，P=0．035）。按瓦格纳（Wanger）系统对糖尿病足病变严重程度进行分级，治疗组27例2级病变患者有效率为88．89％（24／27），显著高于对照组67．86％（18／28）（X^2=4．60，P=0．032）；3级病变治疗组19例有效率为73．86％（14／19），与对照组的63．15％（12／19）比较，差异无统计学意义（X^2=0．49，P=0．364）。结论德莫林联合纳米银医用抗菌敷料能改善2级糖尿病足部慢性溃疡的愈合，但对于3级以上病变效果不明显。Objective To evaluate the effect of Dermlin, an inorganic activity induced skin wound dressing, in combination with a nano-silver dressing, on chronic diabetic foot ulcer. Methods A total of 93 elderly diabetic patients with chronic foot ulcer were recruited and randomly assigned into the treatment group and the control group. In additional to routine systemic and topical treatment for both groups, the treatment group was given a combination of Dermlin and nano-silver dressngs, while for the control group, iodophor gause was used to cover the ulcer. The two groups were compared on ulcer grading, wound healing time and positive rate of bacterial culture. Results The wound healing time in the treatment group was significantly shorter than that in the control group （（41.6±2.7） d w （61.9±2.9） d, t=-35.09, P=0.0001. Positive rates of bacterial culture for the treatment group at admission, 14 d after admission and 28 d after admission were 88.46%, 23.07% and 15. 38%, respectively, in contrast to 88. 89%, 59. 26% and 40.74, respectively, for the control group at the same time points （X^2=0.01, 6.88, 7.34, P=0. 065, 0. 008, 0. 006）. The rate of effectiveness for the control group was 63.83% （30/47）, clearly lower than the 82.61% for the treatment group （38/46） （X^2=4.17, P=0. 035）. The patients＇ foot ulcers were graded using the Wagner system. In the treatment group, 27 patients with grade 2 ulcers showed an 88.89% effectiveness rate （24/27）, considerably higher than the rate of 67.86% in the control group （18/28） （X2=4.60, P=0.032）. For grade 3 ulcers, the effectiveness rate was 73.86% （14/19） for the treatment group and 63. 15% for the control group （12/19）, with no statistical difference between the two groups （x^2 =0.49, P=0. 364）. Conclusions The combination of Dermlin and Nanosilver can promote healing for grade 2 chronic diabetic foot ulcers, but has no obvious effect on grade 3 ulcers.

关 键 词：糖尿病 糖尿病足 

分 类 号：R587.2[医药卫生—内分泌]