大面积烧伤患者经瘢痕外周静脉置管中磺胺嘧啶银脂质水胶敷料的应用效果研究

摘要

Objective To study the clinical application of sulfadiazine silver lipid water gel dressing in the treatment of large area burn patients with scar peripheral venous catheter. Methods 326 patients with large area burns who underwent second-stage operation from June 2014 to October 2017 in our hospital were selected. According to the random number table method, the patients were divided into the two groups. The two groups were treated with external venous catheterization via a scar. After the catheterization, the observation group (174 cases) was covered with sulfadiazine silver lipid water gel dressing, and then the catheter was fixed with a common casing film. The control group (152 cases) only used ordinary casing film to cover the surrounding skin and catheterization. The local infection rate, skin injury rate, number of patch changes and pain score were observed in the two groups. Results The local infection rate (10.34%) and skin injury rate (8.05%) of the observation group were significantly lower than those of the control group (29.61%, 34.21%), the differences were statistically significant(P＜0.05). The number of patches and pain score of the observation group were significantly less than those of the control group [(1.35±0.34)times,(1.67±1.52)points vs(2.79±1.20)times、(3.98±2.21)points], the differences were statistically significant (P＜0.05). Conclusion The use of the sulfadiazine silver lipid water gel dressing in the peripheral venous catheters of patients with extensive burn wounds can reduce the adhesion damage between the scars on the wound surface of the patient and the casing film, reduce pain in patients, reduce the rate of local infection.%目的:研究磺胺嘧啶银脂质水胶敷料在大面积烧伤患者经瘢痕外周静脉置管的临床应用效果.方法:选取笔者医院2014年6月-2017年10月收治的326例大面积烧伤恢复期行二期手术治疗患者,按随机数表法分为两组,两组均行经瘢痕外周静脉置管,置管后观察组(174例)应用磺胺嘧啶银脂质水胶敷料覆盖,再以普通套管贴膜固定置管;对照组(152例)仅应用普通套管贴膜覆盖周围皮肤及置管.观察两组患者局部感染率、皮肤损伤率、贴膜更换次数及更换时疼痛评分情况.结果:观察组局部感染率(10.34%)、皮肤损伤率(8.05%)均显著低于对照组(29.61%,34.21%),差异有统计学意义(P＜0.05).观察组患者贴膜次数及疼痛评分均显著少于对照组[(1.35±0.34)次,(1.67±1.52)分vs(2.79±1.20)次、(3.98±2.21)分],差异均有统计学意义(P＜0.05).结论:在大面积烧伤患者经瘢痕外周静脉置管中应用磺胺嘧啶银脂质水胶敷料可减少患者创面瘢痕和套管贴膜之间的粘连损伤,减轻患者疼痛,并可降低局部感染率.