胶原酶软膏联合水胶体敷料应用于深Ⅱ度烧伤创面治疗的效果观察  

Observation on the efficacy of collagenase ointment combined with hydrogel dressing in the treatment of deep partial-thickness burn wounds

作　　者：彭玲 吴红 宛仕勇 陈斓 叶子青 周静 Peng Ling;Wu Hong;Wan Shiyong;Chen Lan;Ye Ziqing;Zhou Jing(Department of Burns,Tongren Hospital of Wuhan University&Wuhan Third Hospital,Wuhan 430060,China)

机构地区：[1]武汉大学同仁医院暨武汉市第三医院烧伤科,430060

出　　处：《中华损伤与修复杂志（电子版）》2024年第6期511-516,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的观察胶原酶软膏联合水胶体敷料治疗深Ⅱ度烧伤创面的临床效果。方法选择武汉大学同仁医院暨武汉市第三医院烧伤科2022年1月至2023年6月收治的符合纳入与排除标准的66例深Ⅱ度烧伤患者为研究对象。采用随机数字表法将患者分为观察组和对照组,每组33例。观察组患者采用胶原酶软膏联合水胶体敷料治疗,对照组患者采用碘伏凡士林纱布常规换药治疗。记录2组患者创面愈合时间、创面感染率及创面坏死组织清除率。每次换药完毕时,采用视觉模拟评分法(VAS)评估患者疼痛程度。采用改良温哥华瘢痕量表(mVSS)评估治疗后第3个月和第12个月创面瘢痕情况。结果观察组和对照组创面愈合时间分别为(12.09±1.75)d和(12.97±1.88)d,差异无统计学意义(t=1.935,P=0.057)。观察组创面感染率为9.09%(3/33),对照组为6.06%(2/33),差异无统计学意义(P=1.000)。在治疗后第5~7天,观察组创面坏死组织清除率为(73.91±17.52)%,高于对照组的(58.91±13.30)%,差异有统计学意义(t=3.916,P<0.001)。在治疗后第5~7天,观察组患者换药时VAS评分为(1.94±1.17)分,低于对照组的(2.68±1.03)分,差异有统计学意义(t=3.475,P=0.001)。在治疗后第3个月,观察组mVSS评分厚度评分及总分[(1.54±0.60)分、(8.73±1.71)分]均低于对照组[(1.93±0.63)分、(9.85±1.65)分],差异均有统计学意义(t=2.198,P=0.032;t=2.666,P=0.010)。在治疗后第12个月,观察组mVSS总分[(3.67±1.39)分]低于对照组[(4.38±1.39)分],差异有统计学意义(t=2.181,P=0.047);mVSS各分项评分差异无统计学意义(P>0.05)。结论胶原酶软膏联合水胶体敷料治疗深Ⅱ度烧伤创面具有良好的临床效果,能够减轻创面疼痛,减少坏死组织,抑制瘢痕增生。Objective To evaluate the clinical efficacy of collagenase ointment combined with hydrogel dressing in the treatment of deep partial-thickness burn wounds.Methods A total of 66 patients with deep partial-thickness burn wounds were admitted to Department of Burns,Tongren Hospital of Wuhan University&Wuhan Third Hospital from January 2022 to June 2023 who met the inclusion and exclusion criteria were enrolled as the study subjects.The patients were divided into observation group and control group according to random number table,with 33 patients in each group.The patients in the observation group received collagenase ointment combined with hydrogel dressing treatment,while the patients in the control group received iodine tincture vaseline gauze dressing treatment.The wound healing time,wound infection rate,necrotic tissue clearance rate,pain score,and modified Vancouver scar scale(mVSS)scores at 3 months and 12 months after treatment were recorded for both groups.Results The wound healing time in the observation group and the control group was(12.09±1.75)d and(12.97±1.88)d respectively,with no statistically significant difference(t=1.935,P=0.057).No significant difference was found in wound infection rate between the two groups[9.09%(3/33)vs 6.06%(2/33),P=1.000].From day 5 to day 7 post-treatment,the necrotic tissue debridement rate in the observation group was(73.91±17.52)%,statistically higher than(58.91±13.30)%of the control group(t=3.916,P<0.001).From day 5 to day 7 post-treatment,the mVAS score during changing dressings was 1.94±1.17 in the observation group and 2.68±1.03 in the control group,with statistically significant difference(t=3.475,P=0.001).At 3 months post-treatment,the thickness score on the mVSS scale in the observation group was 1.54±0.60,lower than 1.93±0.63 in the control group(t=2.198,P=0.032),and the total mVSS score in the observation group was 8.73±1.71,lower than 9.85±1.65 in the control group,which was statistically different between the two groups(t=2.666,P=0.010).At 12 months

关 键 词：酶学清创 胶原酶软膏 水胶体敷料 深Ⅱ度烧伤 

分 类 号：R644[医药卫生—外科学]