下肢静脉性溃疡感染常见病原菌分布及治疗效果研究  

Distribution and Therapeutic Effect of Common Pathogenic Bacteria in Venous Lower Extremity Ulcer Infection

作　　者：陈建新[1] 金文海[1] 林铭[1] CHEN Jianxin;JIN Wenhai;LIN Ming(The Second Department of Gastroenterology,Affiliated Hospital of Putian University,Putian,Fujian Province,351100 China)

机构地区：[1]莆田学院附属医院胃肠外二科,福建莆田351100

出　　处：《中外医疗》2022年第8期84-89,共6页China & Foreign Medical Treatment

基　　金：莆田学院校内课题(2019101)。

摘　　要：目的探讨下肢静脉性溃疡病原菌分布及其对溃疡愈合的影响,分析含银敷料对不同种类病原菌的治疗效果。方法选取2018年1月—2021年6月在该院治疗的176例下肢静脉性溃疡患者为研究对象,对溃疡进行清创,采用含银敷料,按照标准湿性疗法换药。以菌种分组进行病情分析,连续观察3周,随访3个月。结果176例患者共检出142株病原菌,以金黄色葡萄球菌(32.4%)、铜绿假单胞菌(25.4%)、大肠埃希菌(11.3%)为主。含银敷料治疗3周后病原菌阳性率为15.9%、伤口面积(7.31±12.37)cm^(2)、pH值(7.12±0.20),疼痛评分(1.30±1.38)分,均较治疗后1~2周及治疗前下降,差异有统计学意义(χ^(2)=150.218,F=73.633、430.336、384.342,P<0.001)。含银敷料治疗2周后不同病原菌转阴率差异有统计学意义(P<0.05),随访期内溃疡愈合155例(88.1%),不同菌种感染患者溃疡愈合率差异无统计学意义(P>0.05)。结论下肢静脉性溃疡病原菌感染率高,以金黄色葡萄球菌、铜绿葡萄球菌、大肠埃希菌为主,影响伤口愈合。含银敷料对不同病原菌抑菌效果显著,细菌种类不影响溃疡短期愈合率。Objective To investigate the distribution of pathogenic bacteria in venous lower extremity ulcer and its effect on ulcer healing,and to analyze the therapeutic effect of silver-containing dressings on different types of pathogenic bacteria.Methods A total of 176 patients with venous lower extremity ulcers treated in the hospital from January 2018 to June 2021 were selected as the research objects.Ulcers were debridement,silver-containing dressings were applied,and dressings were changed according to standard wet therapy.Condition analysis was carried out by bacterial species grouping,continuous observation for 3 weeks,and follow-up for 3 months.Results A total of 142 pathogenic bacteria were detected in 176 patients,mainly Staphylococcus aureus(32.4%),Pseudomonas aeruginosa(25.4%)and Escherichia coli(11.3%).After 3 weeks of silver dressing treatment,the positive rate of pathogenic bacteria was 15.9%,the wound area was(7.31±12.37)cm^(2),the pH value was(7.12±0.20),and the pain score was(1.30±1.38)points.Compared with 1-2 weeks after treatment and before treatment,the difference was statistically significant(χ^(2)=150.218,F=73.633,430.336,384.342,P<0.001).There was a statistically significant difference in the negative rate of different pathogens after 2 weeks of silver-containing dressing treatment(P<0.05).During the follow-up period,155 cases(88.1%)of ulcers healed,and there was no significant difference in ulcer healing rate among patients infected with different bacterial species(P>0.05).Conclusion The infection rate of pathogenic bacteria in venous lower extremity ulcer is high,mainly Staphylococcus aureus,Staphylococcus aeruginosa and Escherichia coli,which affect wound healing.The silver-containing dressing has a significant bacteriostatic effect on different pathogens,and the type of bacteria does not affect the short-term healing rate of ulcers.

关 键 词：静脉性溃疡 病原菌 预后 

分 类 号：R654.4[医药卫生—外科学]