银离子藻酸盐敷料联合抗生素对糖尿病肢端感染的疗效  

Effect of silverion alginate dressing in combination with antibiotics in treatment of diabetic extremity infection

作　　者：郭春兰[1] 席祖洋[1] 王平[1] 戴德兰[1] GUO Chunlan;XI Zuyang;WANG Ping;DAI Delan(Yichang Central People's Hospital, Yichang 443003, Hubei Province, China)

机构地区：[1]湖北省宜昌市中心人民医院三峡大学第一临床医学院,湖北宜昌443003

出　　处：《上海护理》2019年第1期28-32,共5页Shanghai Nursing

基　　金：湖北省宜昌市卫生科技项目(编号A14301-07)

摘　　要：目的观察银离子藻酸盐敷料结合抗生素治疗糖尿病肢端感染的效果,以正确引导银敷料在伤口领域的使用。方法 2013年7月—2016年6月对湖北省宜昌市中心人民医院内分泌科收治的109例糖尿病肢端感染患者进行随机分组治疗。A组遵医嘱静脉输注抗生素,同时局部使用银离子藻酸盐敷料处理; B组不使用抗生素,仅局部使用银离子藻酸盐敷料处理; C组按常规方法处理,即静脉输注抗生素,局部使用凡士林敷料处理。观察期4周,随访6周。比较治疗7 d、14 d、21 d时,3组患者创面病原菌及耐药菌阳性率、感染清除时间、抗生素和银离子敷料使用时间,以及患者的截肢率。结果 A组感染清除时间、创面愈合时间、愈合率和截肢率明显优于B、C组,抗生素使用时间少于C组,银离子敷料的使用时间少于B组,差异均有统计学意义(P <0. 05)。结论银离子藻酸盐敷料结合抗生素治疗对于糖尿病肢端感染具有协同抗菌和促进创面愈合的作用。Objective To investigate the effect of silverion alginate dressing in combination with antibiotics in the treatment of diabetic extremity infection,and to promote the correct use of silver dressing in wounds.Methods From July 2013 to June 2016,a total of 109 cases with diabetic extremity infection in Yichang Central People ’s Hospital were chosen. They were randomly divided into three groups. Group A received intravenous antibiotics and local use of silver ion alginate dressing,group B received only local use of silver ion alginate dressing,and group C received intravenous antibiotics and local use of vaseline dressing. They were observed for 4 weeks,and followed up for 6 weeks. At 7 d,14 d and 21 d of treatment,the positive rates of pathogens and drug-resistant pathogens,time to clearance of infection,use time of antibiotics and silver dressing,and rate of limb amputation were compared among three groups. Results Group A had less time to clearance of infection,less healing time,lower rate of limb amputation and higher wound healing rate than the other two groups( P < 0. 05). Group A had less use time of antibiotics than group C and less use time of silver dressing than group B( P < 0. 05). Conclusion Silverion alginate dressing in combination with antibiotics in the treatment of diabetes extremity infection has synergistic antibacterial activity,and can promote wound healing.

关 键 词：糖尿病 肢端感染 病原菌感染 银离子藻酸盐敷料 抗生素 细菌培养 伤口愈合 

分 类 号：R473.58[医药卫生—护理学]