不同银敷料在慢性伤口治疗中应用效果的对比研究  

A comparative study on application effect of different silver dressings in treatment of patients with chronic wounds

作　　者：郭春兰[1] 邓红艳[1] 屈红玲[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院

出　　处：《护理研究（上旬版）》2015年第4期1170-1175,共6页Chinese Nursing Researsh

基　　金：宜昌市医疗卫生科研项目,编号:A14301-07

摘　　要：[目的]观察比较进口和国产银敷料用于慢性伤口治疗的效果,以指导银敷料在伤口治疗中的合理使用。[方法]对入选的外伤、烧伤、手术等延迟愈合伤口和Ⅱ级~Ⅲ级压疮、糖尿病足溃疡90例病人随机分为两组,A组使用进口的银离子藻酸盐敷料处理,B组使用国产的纳米银敷料处理,两组病人均给予基础治疗,并接受30d的治疗方案,研究结束时伤口未愈者选择外科手术或湿性愈合技术处理至愈合。治疗第7天、第14天、第21天观察伤口的细菌清除率;治疗第10天、第20天、第30天观察伤口面积愈合率及观察期内伤口的愈合情况,并于每次处理伤口时观察评价伤口表现（渗液清除时间、肉芽分级和周围皮肤状况）和敷料参数（病人疼痛感和敷料二次创伤）。[结果]入选病人均完成了30d的疗程观察,A组完全愈合35例、基本愈合7例、有效3例,B组完全愈合21例、基本愈合10例、有效14例,两组差异有统计学意义（P〈0.05）;两组伤口细菌清除率随着时间的延长而增加,治疗第30天时细菌清除率均达100%,差异无统计学意义（P〉0.05）;随着治疗时间延长,两组伤口面积愈合率明显增加、伤口表现也显著改善,疼痛感明显减轻,A组的效果要明显优于B组,敷料二次损伤较B组轻,差异均有统计学意义（P〈0.05）。[结论]两种银敷料均可清除伤口感染和组织的炎症反应,减轻疼痛,促进伤口愈合,可用于慢性伤口的治疗,但银离子藻酸盐敷料的有效性和安全性更优越。Objective：To observe and compare the treatment effect of domestic and imported silver dressings for patients with chronic wounds ,so as to guide the rational use of silver dressings in wound therapy .Methods：A total of 90 patients including trauma ,injury ,delayed wound healing（operation） ,grade Ⅱ Ⅲ pressure sorse and diabetic foot ulcers were randomly divided into group A and B ：patients in group A received the treatment of im‐port silver ion alginate dressing ,and patients in group B received the treatment of domestic nanometer silver dressing .All patients were given basic treatment and received the treatment programs for 30 days .The patients with wound unhealed were cured with surgical operation or moist healing technology to heal at the end of the study .The bacterial clearance rate of wound was observed on the 7th d ,14 th d ,21th d during treatment ,and the healing rate of w ound area and the heal situation of w ound during the observation period w ere observed on the 10th d ,20th d and 30th d during treatment ,then to observe and evaluate the wound performance （exudate re‐moval time ,granulation grading and the surrounding skin condition） and dressing parameters （patients＆#39;pain and secondary trauma of dressing） in each treatment of wounds .Results：All patients received the observation of treatment course for 30 days ,35 cases healed completely in group A ,basic healing in 7 cases and effective in 3 cases;21 cases healed completely in group B ,basic healing in 10 cases and effective in 14 cases ,and there were statistically significant differences between both groups（P〈 0 .05） .Two groups of wound bacterial clearance rate increased with the extension of time .The bacterial clearance rate in both groups reached to 100% on the 30th day of treatment ,there was no statistically significant differences（P〉0 .05） .With the treatment time pro‐longing ,the healing rate of wound area increased significantly ,the wound performance was improved significant‐ly and the s

关 键 词：银离子藻酸盐敷料 纳米银敷料 伤口 慢性 感染 伤口护理 

分 类 号：R473.6[医药卫生—护理学]