银离子敷料在慢性伤口疗效及炎性因子变化的观察  

Changes of serum inflammation factors after silver dressing treatment for chronic wound

作　　者：戴亚芬[1] 韩云芳[1] 农鲁明[1] 徐慧黎[1] 许钰[1] 褚育新[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院骨科,江苏常州213003

出　　处：《中华实验外科杂志》2015年第3期599-600,共2页Chinese Journal of Experimental Surgery

基　　金：江苏省卫生厅面上项目（11201351）

摘　　要：目的 观察银离子敷料对慢性伤口的疗效及患者血清炎性因子的变化.方法 取19例慢性伤口患者为治疗组,40例门诊正常体检者为对照组.治疗组创面经38 -40℃乳酸钠林格氏液清创,采用银离子敷料＋藻酸钙渗液吸收贴覆盖,伤口渗出明显时更换敷料.治疗后2个月时评估治疗有效率;分别于治疗前、治疗后2个月取伤口分泌物行细菌培养,比较治疗前后患者伤口的细菌定植情况;分别于治疗前、治疗后2个月时抽取治疗组患者血清以及对照组血清,酶联免疫吸附试验（ELISA）法检测血清中炎性因子白细胞介素（IL）-6、IL-10、IL-12、肿瘤坏死因子（TNF）-α水平.结果 银离子敷料治疗慢性伤口有效率为89.47％;伤口细菌检出率由治疗前15例降低到治疗后2例;治疗前患者血清中IL-6、IL-10、IL-12、TNF-α水平均较对照组明显升高,差异有统计学意义（P＜0.05）,但治疗后的水平较治疗前有所降低,差异有统计学意义（P＜0.05）.结论 银离子敷料能显著降低慢性伤口中的细菌定植,同时下调患者血清中炎性因子IL-6、IL-10、IL-12、TNF-α水平.Objective To study the effects of silver dressing treatment for chronic wound and changes of serum inflammation factors.Methods 19 chronic wound cases were enrolled as treatment group and 40 cases of normal population for physical examination in clinic as control group.In treatment group,the surface of the wound was cleaned with 38-40 ℃ lactated Ringer＇ s solution,dressed with silver dressing and Calcium alginate exudate absorption.We changed the dressing necessarily when the exudation was obvious.The effective rate of treatment was evaluated after two months.Meanwhile the exudation was taken for bacteria culture before and after treatment for observing the bacteria colonization.And we also detected serum inflammation factors in both groups such as interleukin （IL）-6,IL-10,IL-12 and tumor necrosis factor-α （TNF-α） by enzyme linked immunosorbent assay （ELISA）.Results The effective rate of treatment group was 89.74%.The detection rate of bacteria decreased from 15 cases to 2 cases after treatment.Serum IL-6,IL-10,IL-12 and TNF-α were higher in treatment group before treatment compared with control group（P 〈 0.05）,but they decreased after treatment compared with before treatment （P 〈 0.05）.Conclusion The silver dressing can significantly decrease bacteria colonization in chronic wound and level of IL-6,IL-10,IL-12 and TNF-α in serum.

关 键 词：慢性伤口 银离子敷料 炎性因子 伤口愈合 

分 类 号：R641[医药卫生—外科学]